Glycaemic control in diabetic patients during hospital admission is not optimal

The aim of this pilot study was to evaluate glycaemic control in diabetic patients admitted to hospital.

Patients were prospectively identified at 11 consecutive Wednesdays in one medical and one surgery department and information from the previous three days of admission was collected, including: bedside p-glucose readings, scheduled and supplemental insulin treatment.

In total, 111 observation days were included from 37 diabetic patients (27 medical and ten surgical). P-glucose was measured on average four and 2.5 times daily at the medical and the surgery department, respectively. The median p-glucose level was 8.6 mmol/l (range 4.0-22), with no obvious difference between the two departments and no trend towards improvement observed. Approximately one third of the patients had median p-glucose values > 10 mmol/l. 7% of the patients at the medical and none at the surgery department had a p-glucose < 3 mmol/l. Supplemental insulin was prescribed to the majority of patients at the medical department and to 30% at the surgery department with a median p-glucose threshold of 12 and 14 mmol/l at the two departments, respectively. Supplemental insulin was not given despite being indicated in 37% of the elevated glucose episodes. Increments in scheduled insulin dose were rarely observed despite being indicated.

Despite acceptable median p-glucose levels, hyperglycaemia was frequent. The number of glucose readings was low and clinical inertia was observed, both with regard to intensification the scheduled insulin and with regard to administration of supplemental insulin.

not relevant.

not relevant.