title: Effect of online diabetes training for hospitalists on inpatient glycaemia.
abstract: OBJECTIVE
  An online diabetes course for medical residents led to lower patient blood glucose, but also increased hypoglycaemia despite improved trainee confidence and knowledge. Based on these findings, we determined whether an optimized educational intervention delivered to hospitalists (corresponding to an Acute Physician or Specialist in Acute Hospital Medicine in the UK) improved inpatient glycaemia without concomitant hypoglycaemia.
  
  
  METHODS
  All 22 hospitalists at an academic medical centre were asked to participate in an online curriculum on the management of inpatient dysglycaemia in autumn 2009 and a refresher course in spring 2010.
  
  
  RESULTS
  All hospitalists completed the initial intervention. Median event blood glucose decreased from 9.3 mmol/l (168 mg/dl) pre-intervention to 7.8 mmol/l (141 mg/dl) post-intervention and 8.5 mmol/l (153 mg/dl) post-refresher (P < 0.001 for both). Hospitalizations categorized as hyperglycaemia decreased from 83.3 to 55.6% (P = 0.014), with a trend towards euglycaemia (10-28.9%, P = 0.08) and no change in hypoglycaemia. Hyperglycaemic patient-days decreased from 72.0 to 57.3% (P = 0.004), with greater target glycaemia (27.3-39.4%, P = 0.016) and no change in hypoglycaemia.
  
  
  CONCLUSIONS
  An optimized online educational intervention delivered to hospitalists yielded significant improvements in inpatient glycaemia without increased hypoglycaemia.
authors: Hilda & J. Lester Gabrilove Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Ronald.Tamler@mssm.edu
authors: R
authors: R
authors: Tamler
authors: A S
authors: AS
authors: Dunn
authors: D E
authors: DE
authors: Green
authors: M
authors: M
authors: Skamagas
authors: T L
authors: TL
authors: Breen
authors: H C
authors: HC
authors: Looker
authors: D
authors: D
authors: LeRoith
mesh_terms: D000046:Academic Medical Centers; D001291:Attitude of Health Personnel; D001786:Blood Glucose / Q000032:analysis; D003479:Curriculum; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy / Q000628:therapy; D005260:Female; D020445:Hospitalists / Q000193:education*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D020407:Internet; D008297:Male; D009519:New York City / Q000453:epidemiology; D010549:Personal Satisfaction; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy / Q000628:therapy
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents