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Published on: June 11, 2012
Promoting Type 1 Diabetes Self-care Management in the Hospital: Can It Be Done?
Pamela Combs1, Evelyn Duffy, Mary Beth Modic
1Author Affiliations: Director of the Howley Aspire Nursing and Pathways Program (Dr Combs), Cleveland Clinic Health Space Building; Professor (Dr Duffy), Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland; and Clinical Nurse Specialist (Dr Modic), Office of Advanced Practice, Cleveland Clinic, Ohio.
Purpose:
The specific aim of the study was to determine whether there was an increased time in target glucose range for individuals with type 1 diabetes mellitus who were permitted to self-manage their insulin plan while hospitalized.
Design:
A retrospective chart review was conducted of 60 inpatients with type 1 diabetes mellitus who met the criteria to self-manage their diabetes care with the use of their continuous subcutaneous insulin infusion pump or a multiple daily injection insulin regimen. A comparison of the 2 groups was examined to assess differences in glucose outcomes and glycemic stability.
Results:
Seven hundred fifty-three glucose results were examined. The total number of hypoglycemic events in both groups was 37. The number of glucose values labeled as stable was 405, and the remaining 311 glucose values were categorized as hyperglycemic. There were no statistically significant differences in glucose levels between the 2 groups.
Conclusion:
No patients experienced severe hypoglycemia leading to cognitive impairment or severe hyperglycemia leading to diabetic ketoacidosis. The outcomes of this study suggest that diabetes self-management practices in select individuals hospitalized with type 1 diabetes mellitus can contribute to greater glucose stability and time in targeted glucose range.
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