Inpatient management of diabetes and hyperglycaemia : an audit of Spanish hospitals
Copyright © 2023 The Authors. Published by Elsevier España, S.L.U. All rights reserved..
OBJECTIVES: Evaluation of quality of care for patients with diabetes mellitus admitted to hospitals in Spain.
METHODS: Cross-sectional study in one day that included 1193 (26.7%) patients with type 2 diabetes or hyperglycaemia out of a total of 4468 patients admitted to the internal medicine departments of 53 hospitals in Spain. We collected demographic data, adequacy of capillary glycaemic monitoring, treatment administered during admission, and recommended therapy at discharge.
RESULTS: The median age of the patients was 80 years [74-87], of which 561 (47%) were women, with a Charlson index of 4 points [2-6], and 742 (65%) were fragile. Median blood glucose on admission was 155 mg/dl [119-213]. On the third day, the number of capillary blood glucose levels in target (80-180 mg/dl) at pre-breakfast was 792/1126 (70.3%), pre-lunch 601/1083 (55.4%), pre-dinner 591/1073 (55.0%), and at night 317/529 (59.9%). A total of 35 patients (0.9%) were suffering from hypoglycemia. Treatment during hospitalization was performed with sliding scale insulin in 352 (40.5%) patients, with basal insulin and rapid insulin analogues in 434 (50%), or with diet exclusively in 101 (9.1%). A total of 735 (61.6%) patients had a recent HbA1c value. At discharge, the use of SGLT2i increased significantly (30.1% vs. 21.6%; p < 0.001), as did the use of basal insulin (25.3% vs. 10.1%; p < 0.001).
CONCLUSIONS: There is an excessive use of sliding scale insulin as well as insufficient information on HbA1c values and prescription upon discharge of treatments with cardiovascular benefit.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:223 |
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| Enthalten in: |
Revista clinica espanola - 223(2023), 7 vom: 01. Aug., Seite 387-395 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ena, J [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 17.07.2023 Date Revised 16.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.rceng.2023.04.011 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Inpatient management of diabetes and hyperglycaemia |b an audit of Spanish hospitals |
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| 500 | |a Date Completed 17.07.2023 | ||
| 500 | |a Date Revised 16.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a OBJECTIVES: Evaluation of quality of care for patients with diabetes mellitus admitted to hospitals in Spain | ||
| 520 | |a METHODS: Cross-sectional study in one day that included 1193 (26.7%) patients with type 2 diabetes or hyperglycaemia out of a total of 4468 patients admitted to the internal medicine departments of 53 hospitals in Spain. We collected demographic data, adequacy of capillary glycaemic monitoring, treatment administered during admission, and recommended therapy at discharge | ||
| 520 | |a RESULTS: The median age of the patients was 80 years [74-87], of which 561 (47%) were women, with a Charlson index of 4 points [2-6], and 742 (65%) were fragile. Median blood glucose on admission was 155 mg/dl [119-213]. On the third day, the number of capillary blood glucose levels in target (80-180 mg/dl) at pre-breakfast was 792/1126 (70.3%), pre-lunch 601/1083 (55.4%), pre-dinner 591/1073 (55.0%), and at night 317/529 (59.9%). A total of 35 patients (0.9%) were suffering from hypoglycemia. Treatment during hospitalization was performed with sliding scale insulin in 352 (40.5%) patients, with basal insulin and rapid insulin analogues in 434 (50%), or with diet exclusively in 101 (9.1%). A total of 735 (61.6%) patients had a recent HbA1c value. At discharge, the use of SGLT2i increased significantly (30.1% vs. 21.6%; p < 0.001), as did the use of basal insulin (25.3% vs. 10.1%; p < 0.001) | ||
| 520 | |a CONCLUSIONS: There is an excessive use of sliding scale insulin as well as insufficient information on HbA1c values and prescription upon discharge of treatments with cardiovascular benefit | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Clinical practice guidelines | |
| 650 | 4 | |a Diabetes mellitus | |
| 650 | 4 | |a Estudio de prevalencia | |
| 650 | 4 | |a Guías de práctica clínica | |
| 650 | 4 | |a Hipoglucemiantes | |
| 650 | 4 | |a Hospitalización | |
| 650 | 4 | |a Hospitalization | |
| 650 | 4 | |a Hypoglycaemic agents | |
| 650 | 4 | |a Insulin | |
| 650 | 4 | |a Insulina | |
| 650 | 4 | |a Point-prevalence | |
| 650 | 7 | |a Hypoglycemic Agents |2 NLM | |
| 650 | 7 | |a Blood Glucose |2 NLM | |
| 650 | 7 | |a Glycated Hemoglobin |2 NLM | |
| 650 | 7 | |a Insulin |2 NLM | |
| 650 | 7 | |a Insulin, Regular, Human |2 NLM | |
| 700 | 1 | |a Carretero-Gómez, J |e verfasserin |4 aut | |
| 700 | 1 | |a Manuel-Casas, J |e verfasserin |4 aut | |
| 700 | 1 | |a Casado, P |e verfasserin |4 aut | |
| 700 | 1 | |a Vázquez-Rodríguez, P |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-García, F |e verfasserin |4 aut | |
| 700 | 1 | |a González-González, P |e verfasserin |4 aut | |
| 700 | 1 | |a de Escalante-Yagüela, B |e verfasserin |4 aut | |
| 700 | 1 | |a Gandullo-Moro, M |e verfasserin |4 aut | |
| 700 | 1 | |a Carrasco-Sánchez, F-J |e verfasserin |4 aut | |
| 700 | 0 | |a Diabetes, Obesity and Nutrition Study Group of the Spanish Society of Internal Medicine (SEMI) |e verfasserin |4 aut | |
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