Work

SAT-539 Inpatient Diabetes Management Service is Associated with Improved Glycemic Control and Faster Resolution of Severe Hyperglycemia

Year: 2025

Type: article

Abstract: Disclosure: S. Mehta: None. B. Lalani: None. M. Abusamaan: None. A.P. Demidowich: None. H. Prasad: None. K. Lacy: None. S. Sarkar: Rezolute, Inc.. A. Sidhaye: None. C. Stanback: None. C. Nava Suarez: None. A. Wenz: None. A. Zale: None. M. Zilbermint: Dexcom. N.N. Mathioudakis: None. Inpatient Diabetes Management Service is Associated with Improved Glycemic Control and Faster Resolution of Severe Hyperglycemia. Background: Hospitalized patients with diabetes have an increased risk of complications, leading to increased morbidity and mortality. An inpatient diabetes management service (IDMS) aims to mitigate these risks by improving glycemic control; however, few studies have evaluated the impact of an IDMS on glycemic outcomes. This study sought to assess the effect of an IDMS on glycemic outcomes in hospitalized patients at a high-volume academic setting. Methods: This retrospective study used electronic medical records from two large academic medical centers from 6/30/2019 to 3/31/2023. Patients with conditions that significantly affect glycemic control, such as intensive care unit admission, diagnosis of diabetic ketoacidosis, and current pregnancy, were excluded. Using propensity score matching, we compared glycemic outcomes and insulin dosing between patients seen by IDMS within two days of admission (N=1104) and matched controls (N=3312). Logistic regression analyses adjusted for the duration of hospitalization and other confounders. Results: Patients seen by IDMS had significantly lower daily mean blood glucose values (BGV) of -4 mg/dl, -6 mg/dl, -10 mg/dl, and -7 mg/dl on days 3, 4, 5, and 6, respectively; similarly, daily maximum BGVs were lower at -8 mg/dl, -13 mg/dl, -14 mg/dl, -16 mg/dl, and -10 mg/dl on days 3, 4, 5, 6, and 7, respectively. The minimum BGV was similar between groups, except for day 9, in which it was 15 mg/dl higher in the intervention group. Patients treated by IDMS achieved BGV <300 mg/dl 21% faster during their admission compared to control patients (aHR 0.79 (0.70, 0.89). Mean weighted administered basal and bolus insulin doses trended lower in patients treated by IDMS, though the difference was not statistically significant. Conclusions: The IDMS intervention was associated with significant improvements in glycemic control, including reductions in mean and maximum BGV by up to 16 mg/dL and accelerating the time to control severe hyperglycemia. These findings demonstrate that IDMS teams are more effective than standard hospital management at improving glucose levels. Reducing time in severe hyperglycemia is a national quality marker and may help reduce costs and complications associated with diabetes. Further studies could quantify the cost-effectiveness of these glycemic outcomes. Presentation: Saturday, July 12, 2025

Source: Journal of the Endocrine Society

DOI: 10.1210/jendso/bvaf149.1071