The purpose of this study was to describe hypoglycemia treatment patterns in 2 Midwestern hospitals.To describe hypoglycemia treatment patterns, a retrospective chart review of 210 patients who experienced hypoglycemia while hospitalized at 2 Midwestern hospitals was conducted. A total of 484 episodes of hypoglycemia were analyzed for adherence to the 5 steps of the practice guidelines found in the respective hospital policy manuals.Adherence to practice guidelines was low. There was not a single case of adherence to all 5 steps at either study hospital. Adherence to the steps of the guidelines ranged from a low of 2.1% for completion of a 1-hour post-hypoglycemia treatment blood glucose to a high of 70.9% for documentation of the event.Adherence to hypoglycemia practice guidelines was low. Because of the high prevalence of diabetes in acute care settings, it is imperative that hospital care providers become proficient at basic diabetes management.