Effects of an intervention by a diabetes team in hospitalized patients with diabetes.
OBJECTIVE
Hospitalized patients with diabetes have a prolonged length of stay in the hospital. We conducted a controlled prospective randomized feasibility study of the effects of a diabetes team (a diabetes nurse educator and an endocrinologist) on the length of stay and other outcomes of hospitalization in these patients.


METHODS
A total of 179 hospitalized patients with diabetes were randomly assigned to receive usual care supplemented with (85 patients) or without (94 control patients) a diabetes team intervention. Outcome measures included the length of stay, blood glucose control, and rates of readmission.


RESULTS
For the primary diagnosis of diabetes, the median length of stay was 5.5 days (95% CI 4-8 days) for patients who received diabetes team intervention and 7.5 days (5-11 days) for the control patients (NS). For the secondary diagnosis of diabetes, the median length of stay was 10.0 days (8-13 days) in the intervention group and 10.5 days (8-13 days) in the control group (NS). One month after the team intervention was initiated, 75% of patients in the intervention group were in good glycemic control, compared with 46% in the control group. Readmissions at 3 months after discharge included 13 (15%) patients from the intervention group and 30 (32%) patients in the control group (P = 0.01).


CONCLUSIONS
Randomized controlled prospective trials of clinical interventions in hospitalized patients with diabetes are feasible. Diabetes team intervention appears to reduce the hospital length of stay and to improve glycemic control. Team intervention significantly reduces the rate of recurrent hospitalization.
Koproski
J
J
Department of Medicine, Cabrini Medical Center, New York Medical College, New York, USA.
Pretto
Z
Z
Poretsky
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D006745:Hospital Bed Capacity, 300 to 499; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009519:New York City; D010348:Patient Care Team; D010353:Patient Education as Topic; D011446:Prospective Studies; D016896:Treatment Outcome
D001786:Blood Glucose