Endocrinology

Hypoglycemia Risk Stratification Tool calculator

Enter the published formula inputs below to calculate and interpret this score.

Clinical inputs

Prior hypoglycemia-related emergency or hospital events

events

Allowed range: 0–30 events

Count an emergency visit with a primary hypoglycemia diagnosis or a hospital stay with a principal hypoglycemia diagnosis.

Emergency visits for any reason in the prior 12 months

visits

Allowed range: 0–50 visits

Used when there is no prior hypoglycemia event and the person uses insulin. Fewer than 2 visits can stay low risk if age is below 77 years.

InsulinSulfonylureaSevere or end-stage kidney disease

Age

years

Allowed range: 21–110 years

Age of 77 years or older leaves the low-risk rows that require a younger age.

Result

3 fields remaining

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Primary source

Karter AJ, Warton EM, Lipska KJ, Ralston JD, Moffet HH, Jackson GG, Huang ES, Miller DR. Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use. JAMA Intern Med. DOI: 10.1001/jamainternmed.2017.3844. PMID: 28828479. Figure 2 is a checklist of six mutually exclusive groups for the next 12 months. Three or more prior hypoglycemia-related emergency or hospital events is high risk, above 5 percent. One or two prior events in an insulin user is high risk. No prior events, no insulin, and no sulfonylurea is low risk, below 1 percent. No prior events, no insulin, sulfonylurea use, age younger than 77 years, and no severe or end-stage kidney disease is low risk. No prior events, insulin use, age younger than 77 years, and fewer than 2 emergency visits for any reason in the prior 12 months is low risk. Every other combination is intermediate risk, 1 to 5 percent. Severe or end-stage kidney disease is dialysis or stage 4 or 5, an estimated glomerular filtration rate of 29 mL/min/1.73 m² or lower by the CKD-EPI creatinine equation. The result codes low as 0, intermediate as 1, and high as 2. (2017)

Scope: Adults with type 2 diabetes. Prior hypoglycemia counts an emergency visit with a primary hypoglycemia diagnosis or a hospitalization with a principal hypoglycemia diagnosis.

Last reviewed 2026-10-17

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Professional use only

For qualified clinicians. Independently verify inputs, calculations, source guidance, and applicability before any clinical action. This calculator does not replace clinical judgment.

Source: Karter AJ, Warton EM, Lipska KJ, Ralston JD, Moffet HH, Jackson GG, Huang ES, Miller DR. Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use. JAMA Intern Med. DOI: 10.1001/jamainternmed.2017.3844. PMID: 28828479. Figure 2 is a checklist of six mutually exclusive groups for the next 12 months. Three or more prior hypoglycemia-related emergency or hospital events is high risk, above 5 percent. One or two prior events in an insulin user is high risk. No prior events, no insulin, and no sulfonylurea is low risk, below 1 percent. No prior events, no insulin, sulfonylurea use, age younger than 77 years, and no severe or end-stage kidney disease is low risk. No prior events, insulin use, age younger than 77 years, and fewer than 2 emergency visits for any reason in the prior 12 months is low risk. Every other combination is intermediate risk, 1 to 5 percent. Severe or end-stage kidney disease is dialysis or stage 4 or 5, an estimated glomerular filtration rate of 29 mL/min/1.73 m² or lower by the CKD-EPI creatinine equation. The result codes low as 0, intermediate as 1, and high as 2. (2017)

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Clinical inputs

Prior hypoglycemia-related emergency or hospital eventsAccepted range: 0 to 30
Emergency visits for any reason in the prior 12 monthsAccepted range: 0 to 50
Insulin
Sulfonylurea
Severe or end-stage kidney disease
Age (years)Accepted range: 21 to 110

Primary source

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