Trends in glycemic control over a 2-year period in 126 US hospitals

J Hosp Med. 2013 Mar;8(3):121-5. doi: 10.1002/jhm.1997. Epub 2012 Dec 19.

Abstract

Background: Cross-sectional data on inpatient glucose control in a large sample of US hospitals are now available, but little is known about changes in glycemic control over time in these institutions.

Objective: To evaluate trends in glycemic control in US hospitals over 2 years.

Design: Retrospective analysis.

Methods: Point-of-care blood glucose (POC-BG) test results at 126 hospitals during January to December 2007 and January to December 2009 were extracted using the Remote Automated Laboratory System-Plus (Medical Automation Systems, Charlottesville, VA), and patient-day-weighted mean glucose levels were compared.

Setting/patients: Hospitalized patients.

Results: A total of 12,541,929 POC-BG measurements from 1,010,705 patients were analyzed for 2007, and 10,659,418 POC-BG measurements from 656,206 patients were analyzed for 2009. Patient-day-weighted mean POC-BG in 2009 decreased by 5 mg/dL in the non-intensive care unit (non-ICU) data compared with that in 2007 (154 mg/dL vs 159 mg/dL, respectively; P < 0.001). However, POC-BG values were clinically unchanged in intensive care unit (ICU) data from 2009 vs 2007 (167 mg/dL vs 166 mg/dL; P < 0.001). From 2007 to 2009, the proportion of patient-day-weighted mean POC-BGs that were >180 mg/dL declined from 28% to 25% in non-ICU patients (P < 0.001), but not in ICU. Decreases in patient-day-weighted mean POC-BG values in non-ICU patients were significant regardless of hospital size, type, and geographic region (all P < 0.001), but similar decreases were not found in ICU data.

Conclusions: In this first analysis of glucose changes in US hospitals, improvements over 2 years occurred in non-ICU patients. Ongoing analysis will determine whether this trend continues.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / physiology*
  • Glycemic Index / physiology*
  • Hospitals / trends*
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / epidemiology
  • Hyperglycemia / therapy
  • Hypoglycemia / blood
  • Hypoglycemia / epidemiology
  • Hypoglycemia / therapy
  • Point-of-Care Systems / trends*
  • Retrospective Studies
  • United States / epidemiology

Substances

  • Blood Glucose