OBJECTIVES: To determine the effects of a guideline-derived resident educational program on inpatient glycemic control and length of hospital stay (LOS). METHODS: We compared the following variables before and after resident education: percentage of patients on basal-plus-bolus regimens, mean fingerstick glucose (FSG), LOS, and rates of hypoglycemia (FSG<70 mg/dL) and severe hypoglycemia (FSG<40 mg/dL). A two-tailed t test was used for all continuous data and P<0.05 was considered statistically significant. RESULTS: After education, more patients (23% vs 8%; P=0.024) were placed on basal-plus-bolus regimens. We observed a decrease in mean FSG (158.7 mg/dL vs 165.1 mg/dL; P=0.028) and LOS (5.03 days vs 6.98 days; P=0.042). Rates of hypoglycemia (4.6% vs 1.5%; P<0.001) and severe hypoglycemia (0.71% vs 0.24%; P=0.089) increased. CONCLUSIONS: Our resident educational program significantly increased the number of patients receiving guideline-based inpatient insulin therapy and was associated with a reduction in mean FSG and LOS. Rates of hypoglycemia showed a statistically significant increase, whereas rates of severe hypoglycemia did not. Larger multicenter studies with adjustment for potential confounders are needed to further assess the impact of educational interventions on inpatient glycemic control.
OBJECTIVES: To determine the effects of a guideline-derived resident educational program on inpatient glycemic control and length of hospital stay (LOS). METHODS: We compared the following variables before and after resident education: percentage of patients on basal-plus-bolus regimens, mean fingerstick glucose (FSG), LOS, and rates of hypoglycemia (FSG<70 mg/dL) and severe hypoglycemia (FSG<40 mg/dL). A two-tailed t test was used for all continuous data and P<0.05 was considered statistically significant. RESULTS: After education, more patients (23% vs 8%; P=0.024) were placed on basal-plus-bolus regimens. We observed a decrease in mean FSG (158.7 mg/dL vs 165.1 mg/dL; P=0.028) and LOS (5.03 days vs 6.98 days; P=0.042). Rates of hypoglycemia (4.6% vs 1.5%; P<0.001) and severe hypoglycemia (0.71% vs 0.24%; P=0.089) increased. CONCLUSIONS: Our resident educational program significantly increased the number of patients receiving guideline-based inpatient insulin therapy and was associated with a reduction in mean FSG and LOS. Rates of hypoglycemia showed a statistically significant increase, whereas rates of severe hypoglycemia did not. Larger multicenter studies with adjustment for potential confounders are needed to further assess the impact of educational interventions on inpatient glycemic control.
Authors: William B Horton; Sidney Law; Monika Darji; Mark R Conaway; Mikhail Y Akbashev; Nancy T Kubiak; Jennifer L Kirby; S Calvin Thigpen Journal: Endocr Pract Date: 2019-08-14 Impact factor: 3.443
Authors: Jennita G Meinema; Nienke Buwalda; Faridi S van Etten-Jamaludin; Mechteld R M Visser; Nynke van Dijk Journal: Acad Med Date: 2019-02 Impact factor: 6.893
Authors: Nestoras Mathioudakis; Holly Bashura; LaPricia Boyér; Susan Langan; Bama S Padmanaban; Shamil Fayzullin; Sam Sokolinsky; Sherita Hill Golden Journal: J Med Educ Curric Dev Date: 2019-07-15