Is there a "july effect" for inpatient glycemic control?

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Is there a "july effect" for inpatient glycemic control?

Endocr Pract. 2014 Sep 1;20(9):919-24

Authors: Nicolas K, Raroque S, Rowland DY, Chaiban JT

OBJECTIVE: The period of resident turnover in teaching hospitals is considered by some to worsen health outcomes and is called the "July effect." We sought to study glycemic control in patients admitted to medical floors and identify any adverse outcomes related to a "July effect."
METHODS: This was a single-center retrospective cohort study that compared inpatient glycemic control at the start and end of a single academic year (July 2009 to June 2010). A total of 108 patients with a diagnosis of diabetes mellitus were included in the first group (Group 1: July to September 2009), and 134 were in the second group (Group 2: April to June 2010). Four capillary blood glucose measurements were taken from Days 2 to 6 of hospitalization, and clinical data pertinent to glycemic management were collected.
RESULTS: Data analysis showed no significant difference in the overall inpatient glycemic control between the 2 groups. The mean glucose levels were 168.67 mg/dL and 168.59 mg/dL for Groups 1 and 2, respectively. Overall, 67% of patients in Group 1 and 72.9% in Group 2 were within a blood glucose range of 70 to 179 mg/dL, and 32% of patients in Group 1 and 44.1% of patients in Group 2 were within the range of 140 to 179 mg/dL. Hypoglycemia occurred in 17% and 18.6% of Groups 1 and 2, respectively. No difference in diabetes treatment ordering practices of residents was detected.
CONCLUSION: This study did not show any evidence to support the "July effect" on overall inpatient glycemic control.

PMID: 25253224 [PubMed - in process]

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