Assessing Inpatient Glycemic Control:

What Are the Next Steps?
J Diabetes Sci Technol Vol 6, Issue 2, March 2012

Glucometrics has been defined as the “systematic analysis of inpatient blood glucose data.” The rationale for tracking and reporting inpatient glucose control statistics is based on several factors.

• First, there are clinical scenarios where better glucose control has been shown to improve patient outcomes, and hospitals will want to know if hyperglycemia is managed adequately in those population subsets.

• Second, several U.S. quality improvement organizations have recognized the value of better glycemic management; some have developed educational resources to help institutions achieve better inpatient diabetes and hyperglycemia care.

• Third, a recent survey of U.S. hospitals indicated that many have either fully or partially implemented inpatient diabetes quality improvement programs and as these initiatives go live, they will require metrics by which to assess their impact on glucose control. Yet, nearly one-third of these hospitals have indicated that they had no metrics in place to assess the outcomes of their glucose management programs.

• Finally, pay-for-performance requirements are beginning to emerge that are applicable to inpatient diabetes management. Reports on the status of inpatient glucose control in large samples of hospitals are now available.

Which Metric Should be Used? more >

Update on Inpatient Glycemic Control in Hospitals in the United States
Christine M. Swanson, MD; Daniel J. Potter, MA; Gail L. Kongable, MSN, FNP; Curtiss B. Cook, MD

Many quality improvement organizations have been focusing on improving the management of inpatient hyperglycemia. A recent survey of hospitals in the United States demonstrated that the frequencies of hypoglycemia and hyperglycemia were the top 2 metrics of interest to hospitals, and many hospitals have either fully or at least partially implemented inpatient diabetes quality improvement programs. Several quality improvement organizations are promoting the need for better inpatient glycemic control and have developed educational resources to help hospitals achieve better management.

We can now provide an update from more than 500 hospitals—the largest sampling to date—and further describe differences in glucose control stratified by hospital characteristics. Methods... more >

Characterizing Glucose Changes Antecedent to Hypoglycemic Events in the Intensive Care Unit
Curtiss B Cook, M.D., Daniel J Potter, M.A., Gail L Kongable, M.S.N, F.N.P.

Many factors can contribute to inpatient hypoglycemia. Underlying illnesses (e.g., renal failure or advanced liver disease), malnutrition, advanced age, and infections are all associated with hypoglycemia. In hospitalized patients additional risks for hypoglycemia are related to the use of therapies for management of high glucose levels or to the disruption of nutritional intake while receiving anti-hyperglycemic therapy.

More recently, delays in glucose measurement have been associated with a greater risk of hypoglycemia in patients receiving insulin infusions.

Glucose variability more >

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