Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
Autor: | Marniker Wijesinha, Laurence S. Magder, Kristi D. Silver, Elizabeth M. Lamos, Seba Ramhmdani |
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Rok vydání: | 2017 |
Předmět: |
0301 basic medicine
medicine.medical_specialty 030209 endocrinology & metabolism Hypoglycemia Gastroenterology 03 medical and health sciences 0302 clinical medicine length of stay Internal medicine Diabetes mellitus Internal Medicine medicine In patient Targets and Therapy [Diabetes Metabolic Syndrome and Obesity] Original Research Glycemic Pharmacology business.industry Incidence (epidemiology) Odds ratio renal transplantation medicine.disease infection Transplantation hypoglycemia 030104 developmental biology Endocrinology diabetes mellitus Prospective research business |
Zdroj: | Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy |
ISSN: | 1178-7007 |
Popis: | Elizabeth M Lamos,1 Marniker A Wijesinha,2 Seba Ramhmdani,1 Laurence S Magder,2 Kristi D Silver1 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD,USA Objective: To compare length of stay (LOS) and incidence of hypoglycemic events and infections in hospitalized patients with diabetes mellitus (DM) undergoing renal transplantation, among groups of patients defined by admission glucose and mean inpatient daily glucose. Methods: A retrospective analysis of 190 charts of patients with DM who underwent renal transplantation over a 2-year period was conducted. Patients were grouped according to admission glucose and mean inpatient daily glucose (≤140 mg/dL, 141–180 mg/dL, and >180 mg/dL). Results: Admission glucose was not associated with LOS. A mean inpatient daily glucose of ≤140 mg/dL was associated with a longer LOS compared to a mean inpatient daily glucose of >180 mg/dL (p=0.03). Patients with an admission glucose of ≤140 mg/dL had approximately half the rate of hypoglycemic events compared to those with admission glucose of 141−180mg/dL (odds ratio [OR]=2.1;p=0.02) or >180 mg/dL (OR=1.9;p=0.04). However, patients whose mean daily glucose was ≤140 mg/dL had approximately twice the rate of hypoglycemic events than those whose mean daily glucose was 141−180 mg/dL (OR=0.4;p=0.01) or >180 mg/dL (OR=0.4; p=0.004). The incidence of infections was low and was not associated with admission or mean daily glucose levels. Conclusion: Lower mean daily inpatient glucose levels (≤140 mg/dL) are associated with longer LOS and greater incidence of hypoglycemic episodes in diabetes patients undergoing renal transplantation. Our findings suggest that target blood glucose levels of 140−180 mg/dL may be appropriate in this specific population. Additional prospective research is needed to confirm these findings. Keywords: diabetes mellitus, renal transplantation, length of stay, hypoglycemia, infection |
Databáze: | OpenAIRE |
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