Glycemia management in a Slovenian general hospital
- 79 Downloads
In-hospital hyperglycemia is common and associated with an increased risk of in-hospital mortality and extensive length of stay but there are only few studies on real-life hyperglycemia and diabetes management.
In this cross-sectional, non-interventional, prospective study we analyzed medical charts on glycemia status at our internal medicine department for 5 consecutive months. Patients were grouped by departments and divided into subgroups by diabetes type, etiology and duration. Physicians answered a questionnaire regarding knowledge on national guidelines and personal opinions on the subject.
A total of 7080 capillary blood glucose measurements from 308 patients were included in the study. Patients were of Caucasian origin with a mean age 72.7 ± 10.7 years and 50.3% were male. Of the measurements 63.3% were within glycemia goals, 2.7% in the range of hypoglycemia and 0.3% of hyperglycemic syndromes. The mean value was 8.88 ± 3.5 mmol/l (159.84 ± 63 mg/dl). There were no differences in mean glucose measurements but significant differences in reaching glycemia target goals and frequency of acute complications between intensive care, general ward and palliative care patients. Subgroup analysis confirmed the association between glycemia management and newly discovered diabetes, type 1 diabetes, steroid use and disrupted food intake (p < 0.05 for all).
Our results on in-hospital glycemia management seem comparable to previously published data. Patients with newly discovered diabetes, type 1 diabetes, treated with steroids and those eating improperly should be closely monitored. Additional education on guidelines and steroid-induced hyperglycemia accompanied by updated medical charts represent possible improvements. Quality standards for in-hospital glycemia management should be established.
KeywordsAcute complications Diabetes General hospital Glycemia management Quality standard
Sandra Radoš Krnel, MD, an independent statistician, performed statistical analysis. No funding received.
Conflict of interest
J. Makuc, K. Ravber, and T. Keber declare that they have no competing interests.
- 2.Ena J, Gomez-Huelgas R, Romero-Sanchez M, et al. Hyperglycemia management in patients admitted to internal medicine in Spain: A point-prevalence survey examining adequacy of glycemic control and guideline adherence. Eur J Int Med. 2015;26(6):392–8. doi: 10.1016/j.ejim.2015.04.020.CrossRefGoogle Scholar
- 5.Pieralli F, Bazzini C, Fabbri A, et al. The classification of hospitalized patients with hyperglycemia and its implication on outcome: Results from a prospective observational study in Internal Medicine. Intern Emerg Med. 2016;11(5):649–56. doi: 10.1007/s11739-015-1358-6.CrossRefPubMedGoogle Scholar
- 15.Vrtovec M, Urbančič V. Slovenske smernice za klinično obravnavo sladkorne bolezni tipa 2 pri odraslih osebah 2011. http://endodiab.si/wp-content/uploads/sites/2/2015/12/20.OSKRBABOLNIKOVSHIPERGLIKEMIJOVBOLNINICI.pdf. Accessed 19 Apr 2016.Google Scholar
- 17.Australian Diabetes Society. Guidelines for routine glucose control in hospital 2012. https://diabetessociety.com.au/documents/ADSGuidelinesforRoutineGlucoseControlin HospitalFinal2012_000.pdf. Accessed 19 Apr 2016.Google Scholar