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Hospital discharge algorithm based on admission HbA1c for the management of patients with type 2 diabetes

Authors :
Darin E. Olson
Guillermo E. Umpierrez
Christopher Newton
Francisco J. Pasquel
Sol Jacobs
David Reyes
Limin Peng
Vivian Fonseca
Kathie L. Hermayer
Amna Khan
Dawn Smiley
Source :
Diabetes Care
Publication Year :
2014

Abstract

OBJECTIVE Effective treatment algorithms are needed to guide diabetes care at hospital discharge in general medicine and surgery patients with type 2 diabetes. RESEARCH DESIGN AND METHODS This was a prospective, multicenter open-label study aimed to determine the safety and efficacy of a hospital discharge algorithm based on admission HbA1c. Patients with HbA1c 9% were discharged on oral antidiabetes agents (OADs) plus glargine or basal bolus regimen at 80% of inpatient dose. The primary outcome was HbA1c concentration at 12 weeks after hospital discharge. RESULTS A total of 224 patients were discharged on OAD (36%), combination of OAD and glargine (27%), basal bolus (24%), glargine alone (9%), and diet (4%). The admission HbA1c was 8.7 ± 2.5% (71.6 mmol/mol) and decreased to 7.3 ± 1.5% (56 mmol/mol) at 12 weeks of follow-up (P < 0.001). The change of HbA1c from baseline at 12 weeks after discharge was −0.1 ± 0.6, −0.8 ± 1.0, and −3.2 ± 2.4 in patients with HbA1c 9%, respectively (P < 0.001). Hypoglycemia (7% (31%, P = 0.54). CONCLUSIONS Measurement of HbA1c on admission is beneficial in tailoring treatment regimens at discharge in general medicine and surgery patients with type 2 diabetes.

Details

ISSN :
19355548
Volume :
37
Issue :
11
Database :
OpenAIRE
Journal :
Diabetes care
Accession number :
edsair.doi.dedup.....7a59b516504ddbdb9364a82a7cc85b67