Highlights
- •Improved glucose control during admission was associated with a significant reduction of one year mortality rates.
- •Adequate long term diabetes control wasn’t associated with reduced length of hospital stay or rate of readmissions.
- •Adequate diabetes control during hospitalization didn’t affect the length of hospital stay or the rate of readmission.
Abstract
Introduction
It remains unclear whether diabetic patients with diabetic foot complications benefit
from strict glycemic control during hospitalization The present study investigates
the effect of short- and long-term diabetes control on hospital outcomes including:
in-hospital and one year mortality rates, length of hospital stay and the rate of
repeated admissions.
Methods
Type 2 diabetic patients (n = 341) were hospitalized for diabetic foot complications
at Wolfson Medical Center over a 5 year period (2008–2012). The adequate short-term
glycemic control was defined as average glucose levels between 110 and 180 mg/dL.
HbA1c values below 7% were defined as adequate long–term glycemic control.
Results
The average glucose levels during hospitalization were 179 ± 45 mg/dL and 40% of the
measurements were between 110 and 180 mg/dL. Mean admission HBA1c levels were 8.43% ± 2.26%, and 31% of the values were below 7%. The mean length of
hospital stay was 24.3 ± 22.6 days, 15.0% of the patients needed surgical intervention
during admission, the in-hospital mortality rate was 10.3%, and the rate of 1-year
readmission was 25.1%. Adequate diabetes control during hospitalization was not significantly
associated with reduced in-hospital mortality (hazard ratio, 0.454, 95% confidence
interval 0.186–1.103, p = 0.081). However, adequate diabetes control during hospitalization
lead to significantly decreased one year mortality (hazard ratio, 0.269, 95% confidence
interval 0.707–0.101, p = 0.009). Adequate diabetes control during hospitalization
did not affect the length of hospital stay or the rate of repeated admission.
Conclusions
Improved glucose control during hospital admission (levels between 110 and 180 mg/dL)
was associated with reduction of one year mortality.
Keywords
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Article info
Publication history
Published online: January 10, 2018
Accepted:
January 8,
2018
Received in revised form:
January 7,
2018
Received:
June 7,
2017
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
