Hypoglycemia in diabetes patients is common, morbid, and costly. A TPMG-funded team (led by Drs. Lisa Gilliam and Richard Grant) worked with clinical stakeholders to develop a new expert consensus Kaiser Permanente Northern California (KPNC) clinical guideline called Hypoglycemia on a Page (HOAP). HOAP guides proactive, protocol-driven hypoglycemia prevention in KPNC members with diabetes and was published in the KPNC clinical library in May 2023, and disseminated for use by KPNC primary care physicians and accountable population managers who provide diabetes care. This 2024 Community Health proposal will evaluate a natural experiment by comparing trends in ED visits and hospitalizations for hypoglycemia before and after HOAP dissemination across KPNC. We hypothesize that implementation of HOAP will be associated with fewer ED visits and hospitalizations for hypoglycemia.