NIV Congres

Introduction: The prevalence of hyperglycaemias in patients with diabetes mellitus during admission is high. Prevention and treatment is important to prevent further clinical complications. We have conducted a study evaluating implementation of a new protocol to standardize inpatient care of patients with diabetes mellitus.

Methods: A retrospective study including all glucose measurements of adult patients with diabetes mellitus type 1 or 2 admitted to a surgery department, was performed before and after implementation of the new protocol, which acquired direct consultation of an internist and diabetes specialist nurse at admission, who made a daily treatment program and adjustment scheme based on glucose measurements four times a day by HemoCue201DM glucose point of care (POC) device. We compared the prevalence of hyperglycaemias and hypoglycaemias before and after implementation with logistic regression analyses adjusted for age and gender.

Results: Overall, 360 patients with diabetes mellitus type 1 or 2 with 5322 glucose measurements were included. The risk of developing a hyperglycemia was significantly reduced after implementation of the protocol (22 patients with 65 hyperglycemias) compared to before the intervention (70 patients with 417 hyperglycemias) (RR adjusted 0.24 (95% CI 0.19-0.32)). Overall, 45 patients experienced 95 hypoglycaemias, which did not differ significantly between both groups.

Conclusion: After implementation of a new protocol to standardize inpatient care of diabetes mellitus we established a decrease of the risk to develop a hyperglycaemia with 76% without an increased risk of developing a hypoglycaemia. Implementation of this protocol required frequent glucose measurements which are facilitated by point of care glucose measurements.