My concern with the measurement of hypoglycemia is that our patients have their insulin and antidiabetic agents titrated for their eating habits when they are outside of the hospital. Our patients are frequently not compliant with an appropriate diet. When the patient is hospitalized, the patient is placed on an appropriate consistent carb diet. If the patient's hypoglycemia medications (including insulin) are continued at the home doses at this time, this is when the patient is at risk for hypoglycemic events. While the threshold of glucose < 40 mg/dL is quite low, it is possible for this change in diet to substantially affect the blood glucose when patients have their diet changed to an appropriate diet. This makes this measurement problematic for hospitals when the hospital does its due diligence in educating a patient on an appropriate diet, providing an appropriate diet, and as a result is punished because a patient is not accountable for their own health when they are in the community.