Inpatient glucose control: a glycemic survey of 126 U.S. hospitals

Abstract

was used to extract inpatient point-of-care bedside glucose (POC-BG) tests from 126 hospitals for the period January to December 2007. Patient-day-weighted mean POC-BG and hypoglycemia/hyperglycemia rates were calculated for intensive care unit (ICU) and non-ICU areas. The relationship of POC-BG levels with hospital characteristics was determined. RESULTS:A total of 12,559,305 POC-BG measurements were analyzed: 2,935,167 from the ICU and 9,624,138 from the non-ICU. Patient-day-weighted mean POC-BG was 165 mg/dL for ICU and 166 mg/dL for non-ICU. Hospital hyperglycemia (>180 mg/dL) prevalence was 46.0% for ICU and 31.7% for non-ICU. Hospital hypoglycemia (<70 mg/dL) prevalence was low at 10.1% for ICU and 3.5% for non-ICU. For ICU and non-ICU there was a significant relationship between number of beds and patient-day-weighted mean POC-BG levels, with larger hospitals (!400 beds) having lower patient-day weighted mean POC-BG per patient day than smaller hospitals (<200 beds, P < 0.001). Rural hospitals had higher POC-BG levels compared to urban and academic hospitals (P < 0.05), and hospitals in the West had the lowest values.CONCLUSIONS: POC-BG data captured through automated data management software can support hospital efforts to monitor the status of inpatient glycemic control. From these data, hospital hyperglycemia is common, hypoglycemia prevalence is low, and POC-BG levels vary by hospital characteristics. Increased hospital participation in data collection and reporting may facilitate the creation of a national benchmarking process for the development of best practices and improved inpatient hyperglycemia management.

Glycemic control in the infectious diseases ward; role of clinical pharmacist interventions

“…The reported prevalence of hyperglycemia in hospitalized patients is different based on definition of hyperglycemia and study populations [4]. It ranges from 32% in community hospitals to 80% during the perioperative period in cardiac surgery subjects [5][6][7][8].…”

The clinical impact of hypoglycemia in hospitalized patients

“…Among the people with and without diabetes admitted to an internal medicine ward, the incidence of hypoglycemia (defined as blood glucose <70 mg/dL) varies between 3.5% and 10.5%. 12 Just in patients with diabetes, however, hypoglycemia may occur in 12%-18% of cases, or highest percentage if treated with more aggressive glucose-lowering therapy. 13 In a retrospective review, among more than 4000 admissions in Internal Medicine Department, hypoglycemia was found in 8% of hospitalizations and in 3% of patients admitted.…”

Design and Implementation of a Web-Based Reporting and Benchmarking Center for Inpatient Glucometrics

“…Physician experts involved with SHM's GCMI program drew on their own experience, input from institutions enrolled in GCMI, prior SHM publications, the Yale glucometrics experience, and early published benchmarking studies 15,[25][26][27][28][29] to devise a set of glucometrics. Glucometrics can be expressed using each BG test, each patient day, or each patient stay (ie, hospitalization) as a unit of analysis.…”