Antidiabetic therapy before and 1 year after discharge for patients manifesting in-hospital hyperglycemia

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Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Michael Waddell1, Samuel J Flanders, Adam Golas

  • 1Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN 46202, USA.

Postgraduate Medicine
|June 4, 2009
PubMed

Insights

Hyperglycemia management intensified during hospitalization for patients with diabetes mellitus (DM). Post-discharge care saw increased use of insulin and oral hypoglycemic agents (OHAs) for better diabetes management.

Area of Science:

  • Endocrinology
  • Internal Medicine
  • Pharmacology

Background:

  • Limited understanding of hyperglycemia management outside of inpatient settings.
  • Focus on inpatient hyperglycemia impact, neglecting pre- and post-admission care.

Purpose of the Study:

  • To evaluate hyperglycemia management strategies before, during, and after hospital admission.
  • To analyze antidiabetic medication use across different care transition points.

Main Methods:

  • Retrospective analysis of a managed care outpatient database linked to inpatient data (2003-2006).
  • Inclusion of 8547 patients, with detailed medication data for 2898.
  • Determination of diabetes mellitus (DM) status using ICD-9 codes.

Main Results:

  • Nearly 60% of patients had DM or hyperglycemia; 19.5% had pre-existing DM, 9.6% were newly diagnosed.
  • Antidiabetic therapy intensified during admission, primarily with insulin.
  • Post-discharge medication use doubled, with increased use of oral hypoglycemic agents (OHAs) and insulin.

Conclusions:

  • Hyperglycemia management intensified for DM+ patients, with insulin used during hospitalization and both insulin and OHAs post-discharge.
  • Improved understanding of diabetes care transitions can enhance discharge planning and patient outcomes.
Abstract

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