Daily Inpatient Glycemic Survey (DINGS): A Process to Remotely Identify and Assist in the Management of Hospitalized Patients with Diabetes and Hyperglycemia |
| |
| Institution: | 1. From the Stratton VA Medical Center, Department of Medicine, Albany Medical College, Albany, New York;2. Albany Medical College, Department of Surgery Albany, New York;3. Emory University, Department of Medicine, Division of Endocrinology, Atlanta, Georgia.;1. Endocrine Section, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.;2. Puerto Rico Clinical and Translational Research Consortium, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.;1. Division of Nephrology, Department of Medicine, Veterans Affairs Saint Louis Health Care System, Saint Louis, Missouri, USA;2. Research and Development, Veterans Affairs Saint Louis Health Care System, Saint Louis, Missouri, USA;1. From the Division of Hospital Medicine, Department of Medicine, University of California, San Diego, San Diego, California.;2. Center for Innovation and Improvement Science, University of California, San Diego, San Diego, California.;3. Division of Endocrinology, Department of Medicine, University of California, San Diego, San Diego, California.;4. Department of Nursing Education, Development & Research, University of California, San Diego, San Diego, California. |
| |
| Abstract: | Objective: Hyperglycemia, hypoglycemia, and glycemic variability have been associated with increased morbidity, mortality, and overall costs of care in hospitalized patients. At the Stratton VA Medical Center in Albany, New York, a process aimed to improve inpatient glycemic control by remotely assisting primary care teams in the management of hyperglycemia and diabetes was designed.Methods: An electronic query comprised of hospitalized patients with glucose values <70 mg/dL or >350 mg/dL is generated daily. Electronic medical records (EMRs) are individually reviewed by diabetes specialist providers, and management recommendations are sent to primary care teams when applicable. Glucose data was retrospectively examined before and after the establishment of the daily inpatient glycemic survey (DINGS) process, and rates of hyperglycemia and hypoglycemia were compared.Results: Patient-day mean glucose slightly but significantly decreased from 177.6 ± 64.4 to 173.2 ± 59.4 mg/dL (P<.001). The percentage of patient-days with any value >350 mg/dL also decreased from 9.69 to 7.36% (P<.001), while the percentage of patient-days with mean glucose values in the range of 90 to 180 mg/dL increased from 58.1 to 61.4% (P<.001). Glycemic variability, assessed by the SD of glucose, significantly decreased from 53.9 to 49.8 mg/dL (P<.001). Moreover, rates of hypoglycemia (<70 mg/dL) decreased significantly by 41% (P<.001).Conclusion: Quality metrics of inpatient glycemic control improved significantly after the establishment of the DINGS process within our facility. Prospective controlled studies are needed to confirm a causal association.Abbreviations: DINGS = daily inpatient glycemic survey EMR = electronic medical record HbA1c = glycated hemoglobin ICU = intensive care unit VA = Veterans Affairs |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
