A workable model for the management of hyperglycemia in non-critically ill patients in an Asian population

• Published in: Postgraduate medicine Vol. 127; no. 8; p. 796
• Main Authors: Lin, Shi-Dou, Tu, Shih-Te, Lin, Mei-Jung, Jhang, Ya-Leng, Hsieh, Ming-Chia
• Format: Journal Article
• Language: English
• Published: England 01.01.2015
• Subjects: Asian Continental Ancestry Group; Blood Glucose; Case-Control Studies; Decision Support Systems, Clinical - organization & administration; Female; Hospitals, Teaching - statistics & numerical data; Humans; Hyperglycemia - drug therapy; Hyperglycemia - ethnology; Hypoglycemia - ethnology; Hypoglycemic Agents - therapeutic use; Inpatients; Inservice Training; Male; Medical Order Entry Systems; Patient Care Team; Primary Health Care; Taiwan - epidemiology; Taiwan; inpatient hyperglycemia; diabetes; Computerized reminder; consultant team
• ISSN: 1941-9260
• DOI: 10.1080/00325481.2015.1080113

The clinical efficacy of applying a western model for managing hyperglycemia in hospitalized patients in Asia has not been studied. For this observational case-control study, we divided six medical wards into two groups, an intervention group and a control group. The intervention group, consisting three medical wards on the same floor, received care under a computer-assisted consulting model in which special care was automatically indicated for patients who had two successive high glucose measurements in 1 day. The control group, consisting of another three medical wards distributed on different floors, received regular care. Outcome measures were baseline and post-intervention patient-day weighted mean glucose, percentage of patient-day weighted glucose ≥180 mg/dL, proportion of glucose level 100-180 mg/dL, and prevalence of inpatient hyperglycemia (>180 mg/dL) and hypoglycemia (individual measurement <70 mg/dL and patient-day with any measurement <70 mg/dL). At baseline, the patient-day weighted mean glucose level was 181.6 mg/dL. All parameters were comparable between the intervention and control groups with the exception of prevalence of hypoglycemia, which was found to be higher in the intervention group. After intervention, patient-day weighted mean glucose levels for intervention and control groups were 169.9 mg/dL and 176.7 mg/dL, respectively (p < 0.001). The intervention group had a reduction in hypoglycemia and the control group an increase. This computer-assisted consulting model was found to be potentially very workable for the management of inpatient hyperglycemia in hospitals with high patient volumes in Asia.