title: Update on inpatient glycemic control in hospitals in the United States.
abstract: OBJECTIVE
  To provide data on glucose control in hospitals in the United States, analyzing measurements from the largest number of facilities to date.
  
  
  METHODS
  Point-of-care bedside glucose (POC-BG) test results were extracted from 575 hospitals from January 2009 to December 2009 by using a laboratory information management system. Glycemic control for patients in the intensive care unit (ICU) and non-ICU areas was assessed by calculating patient-day-weighted mean POC-BG values and rates of hypoglycemia and hyperglycemia. The relationship between POC-BG levels and hospital characteristics was determined.
  
  
  RESULTS
  A total of 49,191,313 POC-BG measurements (12,176,299 ICU and 37,015,014 non-ICU values) were obtained from 3,484,795 inpatients (653,359 in the ICU and 2,831,436 in non-ICU areas). The mean POC-BG was 167 mg/dL for ICU patients and 166 mg/dL for non-ICU patients. The prevalence of hyperglycemia (>180 mg/dL) was 32.2% of patient-days for ICU patients and 32.0% of patient-days for non-ICU patients. The prevalence of hypoglycemia (<70 mg/dL) was 6.3% of patient-days for ICU patients and 5.7% of patient-days for non-ICU patients. Patient-day-weighted mean POC-BG levels varied on the basis of hospital size (P<.01), type (P<.01), and geographic location (P<.01) for ICU and non-ICU patients, with larger hospitals (≥400 beds), academic hospitals, and US hospitals in the West having the lowest mean POC-BG values. The percentage of patient-days in the ICU characterized by hypoglycemia was highest among larger and academic hospitals (P<.05) and least among hospitals in the Northeast (P<.001).
  
  
  CONCLUSIONS
  Hyperglycemia is common in hospitals in the United States, and glycemic control may vary on the basis of hospital characteristics. Increased hospital participation in data collection may support a national benchmarking process for the development of optimal practices to manage inpatient hyperglycemia.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona 85259, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Swanson
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Potter
authors.forename: Gail L
authors.initials: GL
authors.lastname: Kongable
authors.forename: Curtiss B
authors.initials: CB
authors.lastname: Cook
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002984:Clinical Laboratory Information Systems; D005260:Female; D006742:Hospital Bed Capacity; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D007362:Intensive Care Units; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012423:Rural Health; D014481:United States / Q000453:epidemiology; D014504:Urban Health
chemical_list: D001786:Blood Glucose