Derived Time in Range and Other Metrics of Poor Glycemic Control Associated With Adverse Hospital Outcomes in Patients With Diabetes Mellitus Admitted to Non-ICU Wards at a Tertiary-Level Hospital in Colombia: A Cross-Sectional Study.

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  • Additional Information
    • Source:
      Publisher: Hindawi Limited Country of Publication: England NLM ID: 101605237 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6753 (Electronic) NLM ISO Abbreviation: J Diabetes Res Subsets: MEDLINE
    • Publication Information:
      Publication: <2019>-: London, United Kingdom : Hindawi Limited
      Original Publication: Nasr City, Cairo : Hindawi Publishing Corporation, [2013]-
    • Subject Terms:
      Blood Glucose*/metabolism ; Blood Glucose*/analysis ; Glycemic Control* ; Hospital Mortality* ; Tertiary Care Centers* ; Diabetes Mellitus*/blood ; Diabetes Mellitus*/epidemiology ; Hypoglycemia*/epidemiology ; Hypoglycemia*/blood ; Glycated Hemoglobin*/metabolism ; Glycated Hemoglobin*/analysis; Humans ; Cross-Sectional Studies ; Male ; Female ; Colombia/epidemiology ; Middle Aged ; Aged ; Adult ; Hospitalization/statistics & numerical data ; Time Factors
    • Abstract:
      Aim: This study is aimed at assessing the prevalence of poor glycemic control using different metrics and its association with in-hospital adverse outcomes. Methods: This cross-sectional study was conducted in diabetic patients admitted to a third-level hospital in Colombia between January and July 2022. Poor glycemic control was determined using capillary glucose metrics, including mean glucose values outside the target range, derived time in range (dTIR) (100-180 mg/dL) < 70%, coefficient of variation (CV > 36%), and hypoglycemia (<70 mg/dL). Multiple regression models were adjusted for hospital outcomes based on glycemic control, as well as other sociodemographic and clinical covariates. Results: A total of 330 Hispanic patients were included. A total of 27.6% had mean glucose measurements outside the target range, 33% had a high CV, 64.8% had low dTIR, and 28.8% experienced hypoglycemia. The in-hospital mortality rate was 8.8%. An admission HbA1c level greater than 7% was linked to an increased mortality risk ( p = 0.016), as well as a higher average of glucometer readings (186 mg/dL vs. 143 mg/dL; p < 0.001). A lower average of dTIR (41.0% vs. 60.0%; p < 0.001) was also associated with a higher mortality risk. Glycemic variability was correlated with an increased risk of mortality, hypoglycemia, delirium, and length of hospital stay (LOS). Conclusion: A significant number of hospitalized diabetic patients exhibit poor glycemic control, which has been found to be associated with adverse outcomes, including increased mortality. Metrics like dTIR and glycemic variability should be considered as targets for glycemic control, highlighting the need for enhanced management strategies.
      Competing Interests: The authors declare no conflicts of interest.
      (Copyright © 2024 Edwin Mora Garzón et al.)
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    • Contributed Indexing:
      Keywords: diabetes mellitus; glycemic control; inpatient; outcome assessment
    • Accession Number:
      0 (Blood Glucose)
      0 (Glycated Hemoglobin)
      0 (hemoglobin A1c protein, human)
    • Publication Date:
      Date Created: 20240904 Date Completed: 20240904 Latest Revision: 20240906
    • Publication Date:
      20240906
    • Accession Number:
      PMC11371450
    • Accession Number:
      10.1155/2024/3451158
    • Accession Number:
      39228387