How do I install the Es High Risk Hypoglycemia Screening skill?

Run npx skillmds@latest add dromlakhani/es-high-risk-hypoglycemia-screening in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Es High Risk Hypoglycemia Screening safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Es High Risk Hypoglycemia Screening?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Es High Risk Hypoglycemia Screening free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Es High Risk Hypoglycemia Screening?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Es High Risk Hypoglycemia Screening by dromlakhani

Name: Es High Risk Hypoglycemia Screening
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es High Risk Hypoglycemia Screening

Assesses whether a hospitalized insulin-treated patient is at high risk for hypoglycemia using age, BMI, insulin dose, comorbidities, and hypoglycemia history. Triggered by clinician questions such as "Should we consider CGM for this patient?" or "Is this patient high risk for hypoglycemia?"

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Screen for high risk of hypoglycemia

STEP 1 — Gather Information

Collect patient age, weight, height (to calculate BMI), total daily insulin dose (units/kg), comorbidities (CKD stage ≥3, liver failure, cerebrovascular accident, active malignancy, pancreatic disorders, congestive heart failure, infection), history of preadmission or in-hospital hypoglycemia, and awareness of hypoglycemia.

STEP 2 — Rule In / Rule Out

If the patient is not insulin-treated, stop (not applicable). Otherwise, check for any high‑risk criterion: age ≥65 years, BMI ≤27 kg/m², total daily insulin dose ≥0.6 units/kg, presence of any listed comorbidity, hypoglycemia history, or impaired hypoglycemia awareness. If none are present, classify as low risk and proceed to routine POC‑BG monitoring. If any criterion is present, proceed to classification.

STEP 3 — Classify or Stratify

Classify the patient as high risk for hypoglycemia when at least one of the criteria identified in Step 2 is met.

STEP 4 — Decide

For high‑risk patients, initiate real‑time CGM with confirmatory bedside POC‑BG monitoring for insulin dose adjustments per Recommendation 1.1. For low‑risk patients, continue standard POC‑BG monitoring alone.

Clinical Guardrails / Mimics / Pitfalls

Do not rely on CGM alone in patients with extensive skin infections, hypoperfusion, hypovolemia, or those receiving vasoactive/pressor therapy; avoid CGM when acetaminophen >4 g/day, dopamine, vitamin C, or hydroxyurea are being administered. Always confirm CGM‑derived glucose values with POC‑BG before making insulin adjustments. CGM is not appropriate for patients unable to self‑manage devices (e.g., impaired consciousness) without surrogate oversight.

Concrete Clinical Example

A 70‑year‑old woman with type 2 diabetes, BMI 24 kg/m², total daily insulin 0.7 units/kg, and stage 3 CKD has age ≥65, BMI ≤27, insulin dose ≥0.6 units/kg, and CKD – meeting multiple high‑risk criteria. She is classified as high risk and a real‑time CGM with confirmatory POC‑BG is initiated.

Source: Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278

TODO: consider adding scripts/calc.py for the es-high-risk-hypoglycemia-screening calculator

---name: es-high-risk-hypoglycemia-screeningdescription: Assesses whether a hospitalized insulin-treated patient is at high risk for hypoglycemia using age, BMI, insulin dose, comorbidities, and hypoglycemia history. Triggered by clinician questions such as "Should we consider CGM for this patient?" or "Is this patient high risk for hypoglycemia?"---# Screen for high risk of hypoglycemia## STEP 1 — Gather InformationCollect patient age, weight, height (to calculate BMI), total daily insulin dose (units/kg), comorbidities (CKD stage ≥3, liver failure, cerebrovascular accident, active malignancy, pancreatic disorders, congestive heart failure, infection), history of preadmission or in-hospital hypoglycemia, and awareness of hypoglycemia.## STEP 2 — Rule In / Rule OutIf the patient is not insulin-treated, stop (not applicable). Otherwise, check for any high‑risk criterion: age ≥65 years, BMI ≤27 kg/m², total daily insulin dose ≥0.6 units/kg, presence of any listed comorbidity, hypoglycemia history, or impaired hypoglycemia awareness. If none are present, classify as low risk and proceed to routine POC‑BG monitoring. If any criterion is present, proceed to classification.## STEP 3 — Classify or StratifyClassify the patient as high risk for hypoglycemia when at least one of the criteria identified in Step 2 is met.## STEP 4 — DecideFor high‑risk patients, initiate real‑time CGM with confirmatory bedside POC‑BG monitoring for insulin dose adjustments per Recommendation 1.1. For low‑risk patients, continue standard POC‑BG monitoring alone.## Clinical Guardrails / Mimics / PitfallsDo not rely on CGM alone in patients with extensive skin infections, hypoperfusion, hypovolemia, or those receiving vasoactive/pressor therapy; avoid CGM when acetaminophen >4 g/day, dopamine, vitamin C, or hydroxyurea are being administered. Always confirm CGM‑derived glucose values with POC‑BG before making insulin adjustments. CGM is not appropriate for patients unable to self‑manage devices (e.g., impaired consciousness) without surrogate oversight.## Concrete Clinical ExampleA 70‑year‑old woman with type 2 diabetes, BMI 24 kg/m², total daily insulin 0.7 units/kg, and stage 3 CKD has age ≥65, BMI ≤27, insulin dose ≥0.6 units/kg, and CKD – meeting multiple high‑risk criteria. She is classified as high risk and a real‑time CGM with confirmatory POC‑BG is initiated.**Source:** Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278> **TODO:** consider adding scripts/calc.py for the es-high-risk-hypoglycemia-screening calculator

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