title: An individualized inpatient diabetes education and hospital transition program for poorly controlled hospitalized patients with diabetes.
abstract: OBJECTIVE
  To evaluate predictors of outcomes associated with an inpatient diabetes education and discharge support program for hospitalized patients with poorly controlled diabetes (glycated hemoglobin [HbA1c]>9%).
  
  
  METHODS
  Patients participated in individualized diabetes education conducted by a certified diabetes educator (CDE) that included an exploration of barriers and goal setting during hospitalization with telephone follow-up and communication with primary providers at discharge. Predictors of HbA1c reduction, successful follow-up, and readmission were analyzed.
  
  
  RESULTS
  There were 82 subjects, and 48% were insulin naïve. Patients with type 2 diabetes (T2D, n = 58) had a significant decrease in HbA1c at follow-up (-2.8%, P<.0001), while those with type 1 diabetes (T1D, n = 19) did not (+0.02%, P = .96). However, after adjustment for other factors, only increasing age, higher baseline HbA1c, earlier education, and initiation of basal insulin were significant predictors of reduction in HbA1c. Higher area level income and empowerment and earlier education were significant predictors of outpatient follow-up within 30 days. While 28% were admitted for severe hyperglycemia, only 1 patient was readmitted with severe hyperglycemia. Successful phone contact was 77% and 57% with and without the support of non-CDE assistants respectively, but all outcomes were similar.
  
  
  CONCLUSIONS
  The study suggests that an individualized inpatient diabetes education and transition program is associated with a significant reduction in HbA1c that is dependent on baseline HbA1c, older age, initiation of insulin, and earlier enrollment. Additional interventions are needed to ensure better continuity of care.
authors.affiliation: Division of Endocrinology, The Ohio State University, Diabetes & Metabolism.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dungan
authors.affiliation: Division of Endocrinology, The Ohio State University, Diabetes & Metabolism.
authors.forename: Sharon
authors.initials: S
authors.lastname: Lyons
authors.affiliation: The Ohio State University College of Medicine.
authors.forename: Kavya
authors.initials: K
authors.lastname: Manu
authors.affiliation: The Ohio State University College of Public Health, Columbus, Ohio.
authors.forename: Manjusha
authors.initials: M
authors.lastname: Kulkarni
authors.affiliation: The Ohio State University College of Medicine.
authors.forename: Khalid
authors.initials: K
authors.lastname: Ebrahim
authors.affiliation: The Ohio State University College of Public Health, Columbus, Ohio.
authors.forename: Cara
authors.initials: C
authors.lastname: Grantier
authors.affiliation: Division of Endocrinology, The Ohio State University, Diabetes & Metabolism.
authors.forename: Cara
authors.initials: C
authors.lastname: Harris
authors.affiliation: Division of Endocrinology, The Ohio State University, Diabetes & Metabolism.
authors.forename: Dawn
authors.initials: D
authors.lastname: Black
authors.affiliation: Division of Endocrinology, The Ohio State University, Diabetes & Metabolism.
authors.forename: Dara
authors.initials: D
authors.lastname: Schuster
mesh_terms: D003924:Diabetes Mellitus, Type 2; D006442:Glycated Hemoglobin; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D010353:Patient Education as Topic
chemical_list: D006442:Glycated Hemoglobin