Shi-Dou Lin1, Shih-Te Tu1, Mei-Jung Lin1, Ya-Leng Jhang1, Ming-Chia Hsieh1,2,3. 1. a 1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital , Changhua, Taiwan. 2. b 2 College of Medicine, Chung Shan Medical University , Taichung, Taiwan. 3. c 3 Graduate Institute of Integrated Medicine, China Medical University , Taichung, Taiwan.
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.
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.