Endocrine Abstracts

Introduction: Protocols for identifing and managing hyperglycemia and diabetes in hospital are necessary. Glycemic goals in non critical inpatients are:140 mg/ml(preprandial) and 180(posprandial),oral antidiabetic drug(OADs) withdrawn, avoid hypoglycemias, basal/bolus insulin (nor sliding scale) and request glycosylated haemoglobin.

Aims: To evaluate the implementation of a protocol for management of diabetes(PHD) during the years 2009 and 2010 in our Hospital.

Methods: In January2009 we presented a PHD for non critical patients. Educational meetings were given the first 6 months of the year2009. A nurse supervised the protocol fulfillment. We evaluated HbA1c requested, used treatment and variables of results (glucemias for 3–6 correlative days) in a sample of 1367 patients.

Results: PHD was implanted in 70. 5% of the patients evaluated in 2009: 17.7% had sliding scale,5.4% other insulin treatments and 6.4%OADs. In 2010 the proportions were 61.8%, 19.2%, 11.3% and 7.7% respectively. The average glycemias in the first and last day of registered treatment were 182.0±69.1 mg/dL and 162.4±67.8 mg/dL in the group PHD, 164.5±51.4 mg/dL and 161.5±55.2 in the group Insulin in scale, 185.1±64.8 and 169.6±81.6 mg/dl in the group of other insulin treatments, 133.8±35.2 mg/dL and 133.2±38.6 mg/dl in the group OADs, being the difference between glucemias −19.6±64.6 mg/dl, −3.0±48.1, −15.5±85.6 and -0.6±42.7 mg/dL respectively(P<0.01). HbA1c was determined in 37% of patients in 2009 and 47.6% in 2010.

Conclusions: Protocol implementation was better in the first year of evaluation. Less than 50% of diabetic patients had HbA1c during the hospitalization. PHD patients had better control than the others. The results show that it is not enough to design a PHD, it is necessary to supervise and evaluate it constantly.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.