title: Glycemic control and outcomes of hospitalization in noncritically ill patients with type 2 diabetes admitted with cardiac problems or infections.
abstract: OBJECTIVE
  Although the importance of glycemic control is well established for patients with diabetes hospitalized for surgical problems, it has not been supported by clinical studies for patients with diabetes hospitalized on the medical floors.
  
  
  METHODS
  We conducted a retrospective study of 378 patients with type 2 diabetes admitted for cardiac or infectious disease (ID) diagnosis between September 1, 2011, and August 1, 2012. Exclusion criteria included type 1 diabetes, admission to the intensive care unit (ICU), hospital stay shorter than 3 days, and daily glucocorticoid dose >20 mg of methylprednisolone. The primary composite outcome included death during hospitalization, ICU transfer, initiation of enteral or parenteral nutrition, line infection, deep vein thrombosis, pulmonary embolism, rise in plasma creatinine by 1 or >2 mg/dL, new infection, an infection lasting for more than 20 days, and readmission within 30 days and between 1 and 10 months after discharge.
  
  
  RESULTS
  Patients were stratified by mean blood glucose (BG) level: group 1 had mean BG of <180 mg/dL (n = 286; mean BG, 142 ± 23 mg/dL), whereas group 2 had mean BG levels >181 mg/dL (n = 92; mean BG, 218 ± 34 mg/dL; P<.0001). Group 2 had a 46% higher occurrence of the primary outcome (P<.0004). The rate of unfavorable events was greater in cardiac and ID patients with worse glycemic control (group 2).
  
  
  CONCLUSIONS
  Our data strongly support a positive influence of better glycemic control (average glycemia <180 mg/dL or 10 mmol/L) on outcomes of hospitalization in patients with type 2 diabetes.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Boris
authors.initials: B
authors.lastname: Draznin
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Yunjiao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Stacey
authors.initials: S
authors.lastname: Seggelke
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: R Matthew
authors.initials: RM
authors.lastname: Hawkins
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Joanna
authors.initials: J
authors.lastname: Gibbs
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Mark
authors.initials: M
authors.lastname: Bridenstine
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Neda
authors.initials: N
authors.lastname: Rasouli
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
authors.forename: Cecilia Low
authors.initials: CL
authors.lastname: Wang
mesh_terms: D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose