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Strategies to Prevent Readmission in High-Risk Patients with Diabetes: the Importance of an Interdisciplinary Approach


Purpose of Review

Patients with diabetes are known to have higher 30-day readmission rates compared to the general inpatient population. A number of strategies have been shown to be effective in lowering readmission rates.

Recent Findings

A review of the current literature revealed several strategies that have been associated with a decreased risk of readmission in high-risk patients with diabetes. These strategies include inpatient diabetes survival skills education and medication reconciliation prior to discharge to send the patient home with the “right” medications. Other key strategies include scheduling a follow-up phone call soon after discharge and an office visit to adjust the diabetes regimen. The authors identified the most successful strategies to reduce readmissions as well as some institutional barriers to following a transitional care program.


Recent studies have identified risk factors in the diabetes population that are associated with an increased risk of readmission as well as interventions to lower this risk. A standardized transitional care program that focuses on providing interventions while reducing barriers to implementation can contribute to a decreased risk of readmission.

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Fig. 1


Papers of particular interest, published recently, have been highlighted as: • Of importance

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We would like to thank the following colleagues for their willingness to participate in this project: Jenny DeJesus, MSN, NP; Rusty Greene, DNP, NP; Milena Nikolova, MSN, NP; and Esther Wei, MSN, NP, as well as the patient care coordinators, care coordinators, registered nurses, and medicine residents on 5-North and 5-Central that assisted us in this study.

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Corresponding author

Correspondence to Naina Sinha Gregory.

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Conflict of Interest

Naina Sinha Gregory, Jane J. Seley, Savira Kochhar Dargar, Naveen Galla, Linda M. Gerber, and Jennifer I. Lee declare that they have no relevant conflict of interest pertinent to this study.

Human and Animal Rights and Informed Consent

This study involved human subjects. The study received approval from the Weill Cornell Medicine Institutional Review Board. All subjects provided informed consent and ethical standards were followed.

Additional information

This article is part of the Topical Collection on Hospital Management of Diabetes

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Gregory, N.S., Seley, J.J., Dargar, S.K. et al. Strategies to Prevent Readmission in High-Risk Patients with Diabetes: the Importance of an Interdisciplinary Approach. Curr Diab Rep 18, 54 (2018).

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  • Readmission
  • Discharge
  • Inpatient diabetes
  • Inpatient hyperglycemia
  • Transitional care