title: Effect of a targeted glycemic management program on provider response to inpatient hyperglycemia.
abstract: OBJECTIVE
  To report the results of implementation of a Targeted Glycemic Management (TGM) Service pilot, with the goals of improving clinician awareness of available inpatient glycemic management protocols and improving responsiveness to and frequency of severe hyperglycemia.
  
  
  METHODS
  Patients with a blood glucose (BG) level ≥300 mg/dL who were hospitalized on a general medicine unit during three 12-week periods before, during, and after the TGM pilot were compared for responsiveness by the primary team, percentage of subsequent BG measurements between 80 and 180 mg/dL, and frequency of subsequent severe hyperglycemia (BG levels ≥300 mg/dL) and hypoglycemia (BG values <70 mg/dL).
  
  
  RESULTS
  In comparison with pre-TGM and post-TGM periods, more patients during the TGM pilot had a modification of their glycemic regimen in response to severe hyperglycemia (49% versus 73% versus 50%, before, during, and after TGM, respectively; P = .044), and the percentage of patients with ≥50% of subsequent BG measurements in the desired range (27% versus 53% versus 32%; P = .035) was greatest during the TGM period. The incidence of subsequent severe hyperglycemia (20% versus 9% versus 16%; P = .0004) was lowest during the TGM period; however, the incidence of hypoglycemia was similar in all 3 periods (3.9% versus 3.7% versus 3.7%).
  
  
  CONCLUSIONS
  These results indicate that a TGM Service can favorably influence glycemic management practices and improve glycemic control, but ongoing intervention is necessary for maintenance of these results.
authors: University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. calabresea@upmc.edu
authors: Amy C
authors: AC
authors: Donihi
authors: Jolynn M
authors: JM
authors: Gibson
authors: Michelle L
authors: ML
authors: Noschese
authors: Monica M
authors: MM
authors: DiNardo
authors: Glory L
authors: GL
authors: Koerbel
authors: Michelle
authors: M
authors: Curll
authors: Mary T
authors: MT
authors: Korytkowski
mesh_terms: D001786:Blood Glucose; D019468:Disease Management; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000517:prevention & control; D007297:Inpatients
chemical_list: D001786:Blood Glucose