Twelve month glycaemic profile of acute care wards in a tertiary referral hospital in South West Sydney — ASN Events
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  3. Twelve month glycaemic profile of acute care wards in a tertiary referral hospital in South West Sydney

Twelve month glycaemic profile of acute care wards in a tertiary referral hospital in South West Sydney (#343)

Lorraine Pereira 1 , Nadia Manzoor 1 , Hamish Russel 1 , Vincent Wong 1 2 , Namson Lau 1 2
  1. Liverpool Hospital, Liverpool, NSW, Australia
  2. LIVEDIAB CRU, Ingham institute, University of New South Wales, Sydney

Background

Poor glycaemic control in hospital patients is associated with worse clinical outcomes. Most professional organizations recommend a glucose target between 5 to 10 mmol/L for hospitalized people yet few studies have assessed local in-patient glycaemic profiles.

Aims

In early 2014, we initiated a prospective observational study to measure the glycaemic profile of in-patients admitted to acute care wards (medical and surgical) in Liverpool Hospital (located in South West Sydney and the largest tertiary referral hospital in New South Wales).  Our  secondary aim was to determine any change in glycaemic control following the rollout in August 2014 of the NSW’s Department of Health standardized insulin prescribing charts.

Methods

In patients with diabetes have capillary blood glucose (CBG) monitoring as part of routine care. Two weeks of capillary blood glucose  readings recorded on hospital glucometers (Accu-Chek Performa) from 6 acute (non-critical) care wards were extracted using on-board software on a monthly basis. CBGs were analysed by descriptive techniques for the 6 wards and then compared with results during the same time period in 2014. Results are presented as means ± SD with p<0.05 significant.

Results

The mean fasting CBG readings and pre-meal CBG readings were 8.29 ±  2.9 mmol/L and 9.58 ± 3.5 mmol/L respectively, which falls within recommended in-patient targets. The mean daily CBG readings did not significantly differ between months or wards. Among the CBG readings out of target, the majority were hyperglycaemia (35 % > 10 mmol/L and 15 % > 15 mmol/L) with hypoglycaemia much less frequent (<2% were < 4 mmol/L). There were no significant differences between CBG readings following implementation of the new NSW health insulin prescribing charts to the hospital. Comparative findings to 2014 will be presented during the meeting.

Summary

Hyperglycaemia remains the dominant issue for patients admitted to hospital with hypoglycaemia relatively rare. Improved in-patient protocols and education programs for medical and nursing staff should emphasise the importance of hyperglycaemia as part of in-patient glycaemic control.