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Finding the Sweet Spot: the Last Blood Glucose Measured in the Hospital and 30-Day Outcomes—a Retrospective Study

  • Nishant SahniEmail author
  • Gyorgy Simon
  • Rashi Arora
Concise Research Reports

INTRODUCTION

Even though clinicians caring for hospitalized patients frequently encounter abnormal glucose values at hospital discharge, and hyperglycemia is associated with worse hospital outcomes, little data exists on the prognostic relevance of the last blood glucose (BG) measurement in the hospital.1, 2, 3 We parse the association between the last BG measurement in the hospital and 30-day readmission/mortality and test the following hypotheses: (1) Patients with dysglycemia on the last BG measurement in the hospital experience higher rates of 30-day death and readmissions. (2) The risk increases with the severity of dysglycemia (defined as glucose > 100 mg/dL or < 70 mg/dL) regardless of diagnosis of diabetes mellitus (DM).

METHODS

We obtained institutional review board approval from the University of Minnesota and created an electronic medical record (EMR)–derived dataset of 126,527 emergent hospital admissions for 67,308 patients within a six-hospital network in the Twin Cities...

Notes

Funding Sources

Resources used for the research reported in this publication were supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114.

Author Contribution

Dr. Sahni participated in study design, data analysis, and manuscript preparation. Dr. Arora participated in manuscript preparation. Dr. Simon participated in data analysis.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

References

  1. 1.
    Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes. J Clin Endocrinol Metab. 2002;87(3):978–982.  https://doi.org/10.1210/jcem.87.3.8341.CrossRefPubMedGoogle Scholar
  2. 2.
    Malaskovitz J, Hodge C. Addressing glycemic targets from diagnosis to discharge. Diabetes Spectr. 2014;27(3):169–173.  https://doi.org/10.2337/diaspect.27.3.169.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Falciglia M, Freyberg RW, Almenoff PL, D’Alessio DA, Render ML. Hyperglycemia-related mortality in critically ill patients varies with admission diagnosis. Crit Care Med. 2009;37(12):3001–3009.  https://doi.org/10.1097/CCM.0b013e3181b083f7.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Umpierrez GE. Management of Hyperglycemia in HospitalizedPatients in Non-Critical Care Setting: An EndocrineSociety Clinical Practice Guideline. J Clin Endocrinol Metab. 2012;97(1):16–38.CrossRefGoogle Scholar
  5. 5.
    Yamada T, Shojima N, Noma H, Yamauchi T, Kadowaki T. Glycemic control, mortality, and hypoglycemia in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials. Intensive Care Med. 2017;43(1).  https://doi.org/10.1007/s00134-016-4523-0.
  6. 6.
    Bowen ME, Xuan L, Lingvay I, Halm EA. Random blood glucose: a robust risk factor for type 2 diabetes. J Clin Endocrinol Metab. 2015;100(4):1503–1510.  https://doi.org/10.1210/jc.2014-4116.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  1. 1.Division of General Internal MedicineUniversity of MinnesotaMinneapolisUSA
  2. 2.Institute for Health InformaticsUniversity of MinnesotaMinneapolisUSA
  3. 3.Health PartnersSaint PaulUSA

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