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Effect of a Targeted Glycemic Management Program on Provider Response to Inpatient Hyperglycemia.
MedLine Citation:
PMID:  21454237     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: Hyperglycemia is often inadequately treated during hospitalization. To address this, we piloted a Targeted Glycemic Management (TGM) service with the goals of improving clinician awareness of available inpatient glycemic management protocols and improving responsiveness to and frequency of severe hyperglycemia.Methods: Patients with a blood glucose (BG) ≥300 mg/dL who were hospitalized on the general medicine service during three 12-week periods prior to, during, and following the TGM pilot were compared for responsiveness by the primary team, percentage of subsequent BGs between 80 and 180 mg/dL, and frequency of subsequent severe hyperglycemia (BG ≥300 mg/dL) and hypoglycemia (BG< 70 mg/dL).Results: More patients had a modification of their glycemic regimen in response to severe hyperglycemia (49% vs. 73% vs. 50%, p=0.044) and the percentage of patients with ≥50% of subsequent BGs in the desired range (27% vs. 53% vs. 32%, p=0.035) was greater during the TGM period. The incidence of subsequent severe hyperglycemia (20% vs. 9% vs. 16%, p=0.0004) was lower during the TGM period, however, the incidence of hypoglycemia was similar in all three periods (3.9% vs. 3.7% vs. 3.7%).Conclusion: These results indicate that a TGM service can favorably influence glycemic management practices and improve glycemic control, but ongoing intervention is required.
Authors:
Amy C Donihi; Jolynn M Gibson; Michelle Noschese; Monica Dinardo; Glory Koerbel; Michelle Curll; Mary T Korytkowski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-25
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  -     ISSN:  1934-2403     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-15     Citation Subset:  -    
Affiliation:
University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
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