Efficacy of a hyperglycemia treatment program at a Vascular Surgery Department supervised by Endocrinology.

Cirugia espanola

PubMedID: 25882331

Caimari F, González C, Ramos A, Chico A, Cubero JM, Pérez A. Efficacy of a hyperglycemia treatment program at a Vascular Surgery Department supervised by Endocrinology. Cir Esp. 2015;.
AIM
To evaluate the strategy and efficacy of a hyperglycemia treatment program supervised by Endocrinology.

METHODS
All patients with type 2 diabetes hospitalized at the vascular surgery department over a 12 month period were retrospectively reviewed clinical characteristics and hyperglycemia treatment during hospitalization were collected, at discharge and 2-6 month after discharge. Glycemic control was assessed using capillary blood glucose profiles and HbA1c at admission and 2-6 months post-discharge.

RESULTS
A total of 140 hospitalizations of 123 patients were included. The protocol to choose the insulin regimen was applied in 96.4% of patients (22.8% correction dose, 23.6% basal-correction dose and 50% basal-bolus-correction dose [BBC]). Patients with BBC had higher HbA1c (7.76±1.5% vs. 6.78 ±0.8%; P<.001) and mean glycemia on the first day of hospitalization (184.44±59.2 vs. 140.50±31.4mg/dl; P<.001). Mean blood glucose was reduced to 162.15±41.8mg/dl in the middle and 160.79±43.3mg/dl in the last 24h of hospitalization in patients with BBC (P=.007), but did not change in the remaining patients. In 22.1% patients with treatment changes performed at discharge, HbA1c decreased from 8,22±1,6 to 6,85±1,6% at 2-6 months post-discharge (P=.019).

CONCLUSIONS
The hyperglycemia treatment protocol applied by an endocrinologist in the hospital, allows the identification of the appropriate therapy and the improvement of the glycemic control during hospitalization and discharge, supporting its efficacy in clinical practice.