Endocrine Abstracts

Objective: To evaluate the degree of compliance of the glycemic objectives in non-critic-hospitalized patient and determinate the factors associated to the lack of compliance of the aforesaid objectives.

Material and method: Retrospective observational study in hospitalized patients during 2014. Adult patient age 18 or older, who had at least two points of care de glucose measurements (capillary blood glucose) during their hospitalization, were included. By the revising of the computerise-clinic-history, sociodemographic, clinic and administrative datum were obtained. The results of the glycaemia were obtained from electronic devices.

Results: 2610 patients were included, 54.6% were men. The average age was 71.9±14.2 years old (73.7% older than 65 years old). The 73.5% of the patients were hospitalized in medical service. The main diagnoses when they were hospitalized were related with breathing system (20.1%), circulatory system (18.8%) and the central nervous system (11.1%) diseases. The main chronic diseases were diabetes (60.9%), Chronic kidney disease (18.9%), chronic obstructive pulmonary disorder (COPD) (18.4%) and the congestive heart failure (CHF) (17.6%). 49846 glycaemia were analysed (95.8% pre-prandial, 2.9% postprandial and 1.3% night-time) with average values of 176.7±73.9 mg/dl, 250.2±108.2 mg/dl and 203.2±95.3 mg/dl respectively (P<0.001). The 66.7% fulfil at least one of both stablished criterion. 43.0% of patients had a pre-pandial mean glycemic <140 mg/dl, 66.4% of patients had a random blood glucose <180 mg/dl. No differences in hospital stay among patients with good and poor glycemic control (11.1±11.2 versus 10.34±9.4 days) (P=0.081) were found. The factors associated to the lack of compliance of the objectives were diabetes (OR:5,0[IC95%: 4.1–6.1]), the CHF (OR: 1.5[IC95%:1.2–1.8]), the COPD (OR:1.3[IC95%: 1.0–1.6]) and the urgent hospitalization (OR:2.1 [IC95%: 1.6–2.8]).

Conclusions: The glycemic control in hospitalized patients is far from adequate although we did not find differences in hospital stay between patients with / without good glycemic control. We need to update the existent insulinization protocol because with the current, the 33.3% of patients do not meet the goals.