IMPACT OF GLUCOSE MANAGEMENT TEAM ON OUTCOMES OF HOSPITALIZARON IN PATIENTS WITH TYPE 2 DIABETES ADMITTED TO THE MEDICAL SERVICE
| Autor: | Cecilia C. Low Wang, Neda Rasouli, R. Matthew Hawkins, Boris Draznin, Joanna Gibbs, Mark C. Lindsay, Yunjiao J. Wang, Ingrid Hazlett, Stacey A. Seggelke, Kendra A. Young |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes law.invention 03 medical and health sciences 0302 clinical medicine Endocrinology law Diabetes mellitus Clinical endpoint Medical Staff Hospital Medicine Humans 030212 general & internal medicine Intensive care medicine Glycemic Aged Retrospective Studies Aged 80 and over Patient Care Team business.industry Retrospective cohort study Middle Aged medicine.disease Intensive care unit Hospitalization Venous thrombosis Parenteral nutrition Outcome and Process Assessment Health Care Diabetes Mellitus Type 2 Hyperglycemia Emergency medicine Female business |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 22(12) |
| ISSN: | 1530-891X |
| Popis: | To improve glycemic control of hospitalized patients with diabetes and hyperglycemia, many medical centers have established dedicated glucose management teams (GMTs). However, the impact of these specialized teams on clinical outcomes has not been evaluated.We conducted a retrospective study of 440 patients with type 2 diabetes admitted to the medical service for cardiac or infection-related diagnosis. The primary endpoint was a composite outcome of several well-recognized markers of morbidity, consisting of: death during hospitalization, transfer to intensive care unit, initiation of enteral or parenteral nutrition, line infection, new in-hospital infection or infection lasting more than 20 days of hospitalization, deep venous thrombosis or pulmonary embolism, rise in plasma creatinine, and hospital re-admissions.Medical housestaff managed the glycemia in 79% of patients (usual care group), while the GMT managed the glycemia in 21% of patients (GMT group). The primary outcome was similar between cohorts (0.95 events per patient versus 0.99 events per patient in the GMT and usual care cohorts, respectively). For subanalysis, the subjects in both groups were stratified into those with average glycemia of180 mg/dL versus those with glycemia180 mg/dL. We found a significant beneficial impact of glycemic management by the GMT on the composite outcome in patients with average glycemia180 mg/dL during their hospital stay. The number of patients who met primary outcome was significantly higher in the usual care group (40 of 83 patients, 48%) than in the GMT-treated cohort (8 of 33 patients, 25.7%) (P.02).Our data suggest that GMTs may have an important role in managing difficult-to-control hyperglycemia in the inpatient setting.BG = blood glucose GMT = glucose management team HbA1c = hemoglobin A1c ICU = intensive care unit POC = point of care T2D = type 2 diabetes. |
| Databáze: | OpenAIRE |
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