Evaluation of hospital glycemic control at US academic medical centers.
J Hosp Med
; 4(1): 35-44, 2009 Jan.
Article
em En
| MEDLINE
| ID: mdl-19140174
ABSTRACT
OBJECTIVE:
To evaluate contemporary hospital glycemic management in US academic medical centers.DESIGN:
This retrospective cohort study was conducted on patients discharged from 37 academic medical centers between July 1 and September 30, 2004; 1,718 eligible adult patients met at least 1 of the inclusion criteria 2 consecutive blood glucose readings >180 mg/dL within 24 hours, or insulin treatment at any time during hospitalization. We assessed 3 consecutive measurement days of glucose values, glycemic therapy, and additional clinical and laboratory characteristics.RESULTS:
In this diverse cohort, 79% of patients had a prior diagnosis of diabetes, and 84.6% received insulin on the second measurement day. There was wide variation in hospital performance of recommended hospital diabetes care measures such as glycosylated hemoglobin (A1C) assessment (range, 3%-63%) and timely admission laboratory glucose measurement (range, 39%-97%). Median glucose was significantly lower for patients in the intensive care unit (ICU) compared to ward/intermediate care. ICU patients treated with intravenous insulin had significantly lower median glucose when compared to subcutaneous insulin. Only 25% of ICU patients on day 3 had estimated 6 AM glucoseCONCLUSIONS:
Despite frequent insulin use, glucose control was suboptimal. Academic medical centers have opportunities to improve care to meet current American Diabetes Association hospital diabetes care standards.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Índice Glicêmico
/
Hospitalização
/
Hiperglicemia
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2009
Tipo de documento:
Article