Trends in recorded capillary blood glucose and hypoglycaemia in hospitalised patients with diabetes

Jones, Gill; Casey, Heather M.; Perry, Colin; Kennon, Brian; Sainsbury, Christopher

doi:10.1016/j.diabres.2014.01.021

Cited by 17 publications

(10 citation statements)

References 20 publications

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“…24 From a clinical perspective it is of great interest if the undetected low glycemic episodes during nighttime would have any influence on clinical decisions or even on the clinical outcome. [25][26][27] The present study did not aim to provide an answer to this, and it is therefore not possible to derive any conclusions referring to that from the available data.…”

Section: Safetycontrasting

confidence: 47%

Taking a Closer Look—Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients with Type 2 Diabetes Mellitus Under Basal-Bolus Insulin Therapy

Schaupp

Donsa

Neubauer

et al. 2015

Diabetes Technology & Therapeutics

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Section: Safetycontrasting

confidence: 47%

Taking a Closer Look—Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients with Type 2 Diabetes Mellitus Under Basal-Bolus Insulin Therapy

Schaupp

Donsa

Neubauer

et al. 2015

Diabetes Technology & Therapeutics

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“…9 In Scotland 26.2 % of all admissions were associated with mild hypoglycemia. 10 This highlights the high prevalence and potential importance of hypoglycemia for the inpatient population. Given the potentially large and avoidable impact that hypoglycemia may have on LOS, it is important that an accurate quantification of any association is elucidated.…”

Section: Discussionmentioning

confidence: 99%

Hypoglycemia and Clinical Outcomes in Hospitalized Patients With Diabetes: Does Association With Adverse Outcomes Remain When Number of Glucose Tests Performed Is Accounted For?

Jones

Timmons

Cunningham

et al. 2017

J Diabetes Sci Technol

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Background: Hypoglycemia is associated with increased length of stay in hospital patients, but previous studies have not considered the confounding effect of increased hypoglycemia detection associated with increased capillary blood glucose (CBG) measurement in prolonged admissions. We aimed to determine the effect of recorded hypoglycemia on length of stay of hospital inpatients (LOS) when this mathematical association is subtracted. Methods: CBG data were analyzed for inpatients within our health board area (01/2009-01/2015). A simulated CBG data set was generated for each patient with an identical sampling frequency to the measured CBG data set. The mathematical component of increased LOS was determined using the simulated data set. Subtraction of this confounding mathematical association was used to provide measurement of the true clinical association between recorded hypoglycemia (CBG < 4 mmol [< 72mg/dl]) and LOS. Results: A total of 196 962 admissions of 52 475 individuals with known diabetes were analyzed. 68 809 admissions of 29 551 individuals had >4 CBG measurements made and were included in analysis. After subtraction of the mathematical association of increased sample number, the clinical effect of recorded hypoglycemia is reduced—but persists—compared to previous studies. 1-2 days with recorded hypoglycemia has a relatively minor effect on LOS. LOS increases rapidly if there are ≥3 days with recorded hypoglycemia, with an increase of 0.75 days LOS per additional day with hypoglycemia. Conclusions: This technique increases accuracy of economic modeling of the impact of hypoglycemia on health care systems. This could assist study of the impact of hypoglycemia on other outcomes by factoring for bias of increased sample numbers.

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“…[1][2][3][4] In the UK National Diabetes Inpatient Audit, hypoglycaemia occurred in 23.4% of inpatients with diabetes and 2.2% of these patients required parenteral glucose or glucagon. 5 The frequency and severity of hypoglycaemia has been associated with an increase in pre-and post-discharge mortality and length of admission.…”

Section: Introductionmentioning

confidence: 99%

Capillary blood glucose monitoring, inpatient hypoglycaemia and quality of care

et al. 2015

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Aims: Hypoglycaemia confers excess morbidity and mortality. UK guidelines recommend capillary blood glucose (CBG) measurement is repeated 15 minutes following identification and treatment of CBG <4 mmol/L. We assessed adherence to this guidance, influence of initial CBG on time to repeat (TTR), and the impact of a quality improvement intervention on TTR. Conclusions: TTR is a marker of treatment quality in hypoglycaemia and is suboptimal. TTR reduces with worsening initial degree of hypoglycaemia. We have shown that a quality improvement package can produce sustained reduction of TTR. Br J Diabetes Vasc Dis 2015;15:24-26

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Trends in recorded capillary blood glucose and hypoglycaemia in hospitalised patients with diabetes

Cited by 17 publications

References 20 publications

Taking a Closer Look—Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients with Type 2 Diabetes Mellitus Under Basal-Bolus Insulin Therapy

Taking a Closer Look—Continuous Glucose Monitoring in Non-Critically Ill Hospitalized Patients with Type 2 Diabetes Mellitus Under Basal-Bolus Insulin Therapy

Hypoglycemia and Clinical Outcomes in Hospitalized Patients With Diabetes: Does Association With Adverse Outcomes Remain When Number of Glucose Tests Performed Is Accounted For?

Capillary blood glucose monitoring, inpatient hypoglycaemia and quality of care

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