Glycemic Management Workgroup Meeting

August 13, 2026

Glycemic Management Workgroup

Expanded from the Ambulatory Glycemic Management Workgroup to support a helpful,

consistent bundle of perioperative measures.

Purpose: Update and develop measures to supports glycemic management QI efforts

across MPOG. Rationalize number of measures without losing information

Goals for the proposed framework:

• Organize measures into two core domains: Monitoring and Treatment

• Consolidate overlapping legacy measures where possible

• Align with measure reviews (May 2026 QC) and subspecialty recommendations (ie

SAMBA)

Glycemic Management Measures Across MPOG

• We already have many glycemic

management measures, and more are

in development or just released

(ie ambulatory).

• We need to simplify where possible

• Ensure consistent measure specification

language

Proposal 

• Consolidate measures by retiring intraoperative only and retaining perioperative

measures. Will still provide details about which time period a “flag” occurs

• Separate monitoring and treatment into separate measures. Enables more detailed

information on monitoring

• Update time frame for checking from 90 minutes to 60 minutes per review by Dr.

Henson

• Update hypoglycemia measure per recent review by Dr. Duggan

Appropriate Glycemic Monitoring, Perioperative (GLU-15)

Description: Percentage of adult patients undergoing a procedure who receive appropriate glucose monitoring during the

perioperative period, including preoperative glucose assessment for patients with diabetes and follow-up glucose

monitoring after perioperative hyperglycemia and/or insulin administration.

Threshold: 90%

Time Period: Preop start to PACU end

Inclusion:

Adult patients who meet at least one of the following criteria during the measure time period:

• Diabetes diagnosis

• At least one blood glucose level > 180 mg/dL (10.0 mmol/L)

• Administration of intravenous insulin

• Administration of subcutaneous insulin

Exclusion:

• Age < 18 years

• ASA 5 & 6 including Organ Procurement

• Cases with measure duration ≤ 30 minutes

Proposed

Appropriate Glycemic Monitoring, Perioperative (GLU-15)

Success: All applicable glucose monitoring requirements are met during the measure period.

Proposed

TRIGGER / PHASE REQUIRED ACTION TIMING

Diabetic patient ·

Preoperative

Document one blood

glucose

During preoperative phase

Glucose >180 mg/dL (10 mmol/L) · Perioperative

Recheck blood glucose

(if insulin not

administered)

Within 60 minutes

IV insulin bolus

· Perioperative

Recheck blood glucose

Within 60 minutes

IV insulin infusion

· Perioperative

Document blood glucose at initiation and

recheck blood glucose while infusion active

Initiation:

within 60 minutes

Recheck:

every 60 minutes while active

Each reading resets the interval.

Subcutaneous insulin

· Perioperative

Recheck blood glucose

Within 120 minutes

Insulin administered · Perioperative

Document one blood glucose

During PACU phase

Hyperglycemia Treatment, Perioperative (GLU-16)

Description: Percentage of adult patients with a perioperative glucose >180 mg/dL (10 mmol/L) treated with insulin

within 60 minutes.

Threshold: 90%

Time Period: Preop start to PACU end

Inclusion:

All patients with a glucose level > 180 mg/dL (10 mmol/L).

Exclusion:

• Age < 18 years

• ASA 5 & 6 including Organ Procurement

• Cases with measure duration ≤ 30 minutes

• Cesarean Delivery Cases

• Labor Epidurals

Success:

Administration of insulin within 60 minutes of a blood glucose > 180 mg/dL (10 mmol/L).

Note: Similar to GLU-11, but Outpatient procedures are now included.

Proposed

Simplified measures, preserved phase-of-care visibility.

Hyperglycemia Treatment, Outpatient (GLU-17)

Description: Percentage of adult patients undergoing an outpatient procedure with a perioperative glucose

>250 mg/dL (13.9 mmol/L) treated with insulin within 60 minutes

Threshold: 90%

Time Period: Preop start to PACU end

Inclusion:

All patients undergoing an outpatient procedure with glucose level > 250 mg/dL (13.9 mmol/L)

Exclusion:

• Age < 18 years

• ASA 5 & 6 including Organ Procurement

• Any case not determined to be outpatient

• Cases with measure duration ≤ 30 minutes

Success:

Administration of insulin within 60 minutes of a blood glucose > 250 mg/dL (13.9 mmol/L).

Released August 2026

Please note: Measure currently includes patients classified as outpatients, not

necessarily just those at ASCs.

Measure Performance: GLU-17: Hyperglycemia Treatment, Outpatient

July 1, 2025-May 31, 2026

Hypoglycemia Treatment, Perioperative (GLU-18)

Description: Percentage of cases with perioperative hypoglycemia that received treatment with glucose or a

dextrose-containing solution within the specified timeframe: within 30 minutes for glucose <70 mg/dL (3.885mmol/L)

and within 15 minutes for severe hypoglycemia (glucose <54 mg/dL or 3 mmol/L).

Threshold: 90%

Time Period: Preop start to PACU end

Inclusion:

All patients with a glucose level less than 70 mg/dL (3.885mmol/L)

Exclusion:

• ASA 5 & 6 including Organ Procurement

• Labor Epidurals

Success:

Administration of glucose or a dextrose-containing solution within 30 minutes for glucose <70 mg/dL (3.885mmol/L)

or within 15 minutes for severe hypoglycemia (glucose <54 mg/dL or 3 mmol/L).

Proposed

Future measure consideration: Develop a companion monitoring measure to assess timely

glucose rechecks after hypoglycemia treatment per recommendation from May QC Meeting.

Next Steps

• Maintain GLU-11 as specified through 2027 P4P/VBR measurement period

• Refine glucose measure specifications with feedback from the Glycemic Management

Workgroup

• Modify GLU-17 to include ASC cases instead of Outpatient class, based on feedback

from GMW.

• Present finalized measure specifications to the Quality Committee (Goal: Q4 2026)

• Build and release glucose measures to the Dashboard for site validation (Goal: TBD)

• Regroup with Glycemic Management Workgroup for measure feedback (Goal: TBD)

Appendix: Data Definitions

TERM / CLASSIFICATION DEFINITION USED IN MEASURES

Diabetes diagnosis

MPOG Comorbidity: Diabetes Mellitus

— value code 1

Organ Procurement

Procedure Type: Organ Procurement

— value code 1

Outpatient procedure

Admission Type

— value code 501

Not classified as outpatient

Admission Type

— value codes 0, 500, 502, 503, 504, 505, 515

Cesarean Delivery

Obstetric Anesthesia Type

— value codes 1, 2, 7

Labor Epidural

Obstetric Anesthesia Type

— value codes 3 and 6; includes obstetric non-

operative procedures (CPT 01958)

Measure duration

Preop Start

to PACU End