Basal-bolus insulin therapy in postoperative inpatients with diabetes mellitus: directions for future quality-improvement initiatives

AIM: To determine variables associated with hyperglycemia and insulin therapy in postoperative inpatients with diabetes mellitus following a quality-improvement initiative. MATERIALS & METHODS: Patients with diabetes mellitus following an elective surgical procedure (n = 782; 877 surgical procedures) were selected. RESULTS: Age, hemoglobin A(1c) corticosteroids, insulin therapy and year of surgery were associated (p < 0.01) with hyperglycemia. Hemoglobin A(1c), hyperglycemia, case mix index and corticosteroids were associated (p ≤ 0.03) with insulin therapy. Hyperglycemia and use of insulin varied by surgical specialty. CONCLUSION: Data could be used to modify current treatment algorithms. Variations in hyperglycemia and insulin use by surgical specialty require further investigation.