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Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study

BACKGROUND: Hyperglycemia is a common comorbidity in hospitalized patients and may add to adverse outcomes. Various associations have issued guidelines for optimal management of hyperglycemia in ill patients. This study aims to assess the adherence to current guidelines in inpatient setting and the...

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Autores principales: Amrith, B. P, Sethi, Prayas, Soneja, Manish, Vikram, Naval, Kumar, Arvind, Aggarwal, Praveen, Jyotsna, Viveka P., Pandey, R. M., Wig, Naveet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166556/
https://www.ncbi.nlm.nih.gov/pubmed/30294569
http://dx.doi.org/10.4103/ijem.IJEM_698_17
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author Amrith, B. P
Sethi, Prayas
Soneja, Manish
Vikram, Naval
Kumar, Arvind
Aggarwal, Praveen
Jyotsna, Viveka P.
Pandey, R. M.
Wig, Naveet
author_facet Amrith, B. P
Sethi, Prayas
Soneja, Manish
Vikram, Naval
Kumar, Arvind
Aggarwal, Praveen
Jyotsna, Viveka P.
Pandey, R. M.
Wig, Naveet
author_sort Amrith, B. P
collection PubMed
description BACKGROUND: Hyperglycemia is a common comorbidity in hospitalized patients and may add to adverse outcomes. Various associations have issued guidelines for optimal management of hyperglycemia in ill patients. This study aims to assess the adherence to current guidelines in inpatient setting and the impact of educational interventions on the improvement in adherence to guidelines as well as its effect on the level of blood sugar control and patient outcomes. MATERIALS AND METHODS: It was a quasi-experimental pretest and posttest study and was done in three phases, viz., observation of current practices, intervention in the form of educational interventions, and its effect on change in practices and patient outcomes. RESULTS: There was statistically significant 22% increase in the use of recommended insulin regimens (P = 0.028). The proportion of blood sugars within recommended range in the first 48 h, mean daily blood sugars, and the incidence of severe hyperglycemia improved in phase 3 vs phase 1 and was statistically significant. On comparing the subgroups, viz., those who followed and those who did not follow the guidelines, the results of the proportion of blood sugar in recommended range and proportions of blood sugar of more than 250 were found to be statistically significant. CONCLUSION: Dedicated educational interventions help in improving healthcare practices. According to current guidelines, rapid improvement in hyperglycemia and better glycemic control occur with adherence to protocol-based management of hyperglycemia.
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spelling pubmed-61665562018-10-05 Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study Amrith, B. P Sethi, Prayas Soneja, Manish Vikram, Naval Kumar, Arvind Aggarwal, Praveen Jyotsna, Viveka P. Pandey, R. M. Wig, Naveet Indian J Endocrinol Metab Original Article BACKGROUND: Hyperglycemia is a common comorbidity in hospitalized patients and may add to adverse outcomes. Various associations have issued guidelines for optimal management of hyperglycemia in ill patients. This study aims to assess the adherence to current guidelines in inpatient setting and the impact of educational interventions on the improvement in adherence to guidelines as well as its effect on the level of blood sugar control and patient outcomes. MATERIALS AND METHODS: It was a quasi-experimental pretest and posttest study and was done in three phases, viz., observation of current practices, intervention in the form of educational interventions, and its effect on change in practices and patient outcomes. RESULTS: There was statistically significant 22% increase in the use of recommended insulin regimens (P = 0.028). The proportion of blood sugars within recommended range in the first 48 h, mean daily blood sugars, and the incidence of severe hyperglycemia improved in phase 3 vs phase 1 and was statistically significant. On comparing the subgroups, viz., those who followed and those who did not follow the guidelines, the results of the proportion of blood sugar in recommended range and proportions of blood sugar of more than 250 were found to be statistically significant. CONCLUSION: Dedicated educational interventions help in improving healthcare practices. According to current guidelines, rapid improvement in hyperglycemia and better glycemic control occur with adherence to protocol-based management of hyperglycemia. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6166556/ /pubmed/30294569 http://dx.doi.org/10.4103/ijem.IJEM_698_17 Text en Copyright: © 2018 Indian Journal of Endocrinology and Metabolism http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Amrith, B. P
Sethi, Prayas
Soneja, Manish
Vikram, Naval
Kumar, Arvind
Aggarwal, Praveen
Jyotsna, Viveka P.
Pandey, R. M.
Wig, Naveet
Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study
title Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study
title_full Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study
title_fullStr Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study
title_full_unstemmed Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study
title_short Effect of Implementation of ADA/AACE Guidelines on the Management of Hospitalized Hyperglycemic Patients Through Training of Residents: A Tertiary Care Center Study
title_sort effect of implementation of ada/aace guidelines on the management of hospitalized hyperglycemic patients through training of residents: a tertiary care center study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166556/
https://www.ncbi.nlm.nih.gov/pubmed/30294569
http://dx.doi.org/10.4103/ijem.IJEM_698_17
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