title: Analysis of a Guideline-Derived Resident Educational Program on Inpatient Glycemic Control.
abstract: OBJECTIVE
  To determine the effects of a guideline-derived resident educational program on inpatient glycemic control and length of hospital stay (LOS).
  
  
  METHODS
  We compared the following variables before and after resident education: percentage of patients on basal-plus-bolus regimens, mean fingerstick glucose (FSG), LOS, and rates of hypoglycemia (FSG<70 mg/dL) and severe hypoglycemia (FSG<40 mg/dL). A two-tailed t test was used for all continuous data and P<0.05 was considered statistically significant.
  
  
  RESULTS
  After education, more patients (23% vs 8%; P=0.024) were placed on basal-plus-bolus regimens. We observed a decrease in mean FSG (158.7 mg/dL vs 165.1 mg/dL; P=0.028) and LOS (5.03 days vs 6.98 days; P=0.042). Rates of hypoglycemia (4.6% vs 1.5%; P<0.001) and severe hypoglycemia (0.71% vs 0.24%; P=0.089) increased.
  
  
  CONCLUSIONS
  Our resident educational program significantly increased the number of patients receiving guideline-based inpatient insulin therapy and was associated with a reduction in mean FSG and LOS. Rates of hypoglycemia showed a statistically significant increase, whereas rates of severe hypoglycemia did not. Larger multicenter studies with adjustment for potential confounders are needed to further assess the impact of educational interventions on inpatient glycemic control.
authors.affiliation: From the Department of Medicine, University of Mississippi Medical Center, Jackson.
authors.forename: William B
authors.initials: WB
authors.lastname: Horton
authors.affiliation: From the Department of Medicine, University of Mississippi Medical Center, Jackson.
authors.forename: Andrew Q
authors.initials: AQ
authors.lastname: Weeks
authors.affiliation: From the Department of Medicine, University of Mississippi Medical Center, Jackson.
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Rhinewalt
authors.affiliation: From the Department of Medicine, University of Mississippi Medical Center, Jackson.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Ballard
authors.affiliation: From the Department of Medicine, University of Mississippi Medical Center, Jackson.
authors.forename: Frederick H
authors.initials: FH
authors.lastname: Asher
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin