Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study.
Indian J Endocrinol Metab. 2018 Sep-Oct;22(5):616-620
Authors: Amrith BP, Sethi P, Soneja M, Vikram N, Kumar A, Aggarwal P, Jyotsna VP, Pandey RM, Wig N
Background: Hyperglycemia is a common comorbidity in hospitalized patients and may add to adverse outcomes. Various associations have issued guidelines for optimal management of hyperglycemia in ill patients. This study aims to assess the adherence to current guidelines in inpatient setting and the impact of educational interventions on the improvement in adherence to guidelines as well as its effect on the level of blood sugar control and patient outcomes.
Materials and Methods: It was a quasi-experimental pretest and posttest study and was done in three phases, viz., observation of current practices, intervention in the form of educational interventions, and its effect on change in practices and patient outcomes.
Results: There was statistically significant 22% increase in the use of recommended insulin regimens (P = 0.028). The proportion of blood sugars within recommended range in the first 48 h, mean daily blood sugars, and the incidence of severe hyperglycemia improved in phase 3 vs phase 1 and was statistically significant. On comparing the subgroups, viz., those who followed and those who did not follow the guidelines, the results of the proportion of blood sugar in recommended range and proportions of blood sugar of more than 250 were found to be statistically significant.
Conclusion: Dedicated educational interventions help in improving healthcare practices. According to current guidelines, rapid improvement in hyperglycemia and better glycemic control occur with adherence to protocol-based management of hyperglycemia.
PMID: 30294569 [PubMed]