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

Abstract

Objective: The clinical efficacy of applying a western model for managing hyperglycemia in hospitalized patients in Asia has not been studied. Methods: 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). Results: 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. Conclusion: 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.

Keywords:

• Computerized reminder
• consultant team
• diabetes
• inpatient hyperglycemia

Acknowledgments

We thank Hui-Fang Hsiao & Jung-Min Chen of department of the information system at Changhua Christian Hospital, Taiwan, for creating the computerized platform of our study. There is no funding support for this study.

Declaration of interest

SD Lin has received speaker fees from Eli Lilly, NovoNordisk and Sanofi Aventis. ST Tu has received speaker fees from AstraZeneca, Eli Lilly, NovoNordisk and Sanofi Aventis. MC Hsieh has received speaker fees from AstraZeneca, Eli Lilly, NovoNordisk, Sanofi Aventis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes