Effectiveness of an educational intervention on the management of type 2 diabetic patients hospitalized in Internal Medicine: results from the FADOI-DIAMOND study

Abstract

Appropriate management of hyperglycemia is crucial for patients with type 2 diabetes. Aim of the FADOI-DIAMOND study was to evaluate real-world management of type 2 diabetic patients hospitalized in Internal Medicine wards (IMW) and the effects of a standardized educational intervention for IMW staff. DIAMOND has been carried out in 53 Italian IMW, with two cross-sectional surveys interspersed with an educational program (PRE phase and POST phase). In PRE phase, each center reviewed the charts of the last 30 hospitalized patients with known type 2 diabetes. An educational program was conducted in each center by means of the “outreach visit,” a face-to-face meeting between IMW staff and a trained external expert. Six months after, each center repeated the data collection (POST phase), specular to the PRE. A total of 3,167 patients were enrolled (1,588 PRE and 1,579 POST). From PRE phase to POST, patients with registered anthropometric data (54.1 vs. 74.9 %, p < 0.001) and in-hospital/recent measurement of glycated hemoglobin (48.2 vs. 61.4 %, p < 0.005) increased significantly. After educational program, more patients received insulin during hospitalization (68.3 vs. 63.6 %, p = 0.005). A more relevant variation in glycemia during hospitalization was observed in POST phase than PRE (−22.2 vs. −15.5 mg/dL, p < 0.001), without differences as for occurrence of hypoglycemia (12.3 vs. 11.9 %). A one-shot educational intervention led to persistent improvement in the management of hospitalized patients with type 2 diabetes and to significant better glycemic control. Further studies might evaluate the effectiveness of a more aggressive educational program, on both management and outcomes.

Appendix

Members of the FADOI-DIAMOND Study Group

Agnelli F., Agostinelli P., Ambrosca C., Anastasi G., Anastasio L., Annese M., Antonelli A., Antonelli A., Armogida N., Attardo T., Augello G., Baggio G., Baldini T., Ballardini G., Barbato G., Beltramello G., Berti F., Bettoni M., Biscottini B., Borzì V., Caddori A., Campagna G., Campanini M., Cannistraro D., Cantarella S., Cantino E., Carella M., Carta G., Cassati G., Catone B., Cattin L., Cavalli P., Ceraudo A.M., Chiuc M., Cianfrocca C., Ciamei M., Cimpanelli M., Cioni G., Cipriani R., Colombo F., Conte M., Cuccurullo O., D’Amico G., De Ciocchis A., De Siena G., Della Valle M.P., Deorsola B., Di Lillo M., Di Michele D., Di Nucci G.A., Ferrari A., Fontana M., Fontanella A., Formentini G., Fusco P., Gambacorta M., Gambina F., Gargiulo A., Garognoli O., Gatti A., Gaudioso R., Gerardi D., Gerloni R., Girolami B., Gnerre P., Grandi M., Grigoletto C., Gulli G., Hadad Y., Iacono M.A., Iazzetta N., Laccetti M., Landini G., Lattanzi E., Lombardini F., Maffettone A., Malci F., Manfellotto D., Mantega M., Maraldi C., Marengo C., Masala R., Mayer M.C., Mazzone A., Mura S., Musca G., Nicodemo S., Nozzoli C., Orlandini F., Pampana A., Paoletti P.V., Parodi L., Pastorelli R., Paternò Raddusa F., Patti A., Perracchio G., Piccinni A., Piersanti C., Piubello W., Polo M., Rapetti R., Reginelli R., Rinaldi M., Rizzi G., Romagni P., Romano G., Romano M., Rondena M., Rossi A., Sacchetti C., Sansone L., Santi F., Scanelli G., Schettino M., Schimizzi A.M., Sciarappa A., Seghieri G., Serra M. G., Sgroi C., Siri M., Stabilini M., Sulis P., Tassinario S., Topa G., Tesi F., Vannucchi V., Vescovo G., Zerella F., Zuccoli A.