ECE2024 Poster Presentations Late-Breaking (77 abstracts)
Improving the inpatient assessment and management of people with diabetes and frailty by the involvement of the diabetes in reach team
Eka Melson 1,2 , Kashish Gera 1 , Garima Gupta 1 , Hnin Lwin 1 , Anu Thomas 1 , Mohamed Fazil 1 , Kevin Thottungal 1 , Vishnusankar Umasankar 1 , HayMar Tun 1 , Meri Davitadze 3 , Alison Gallagher 1 & Kath Higgins 1,2
1University Hospitals of Leicester; 2University of Leicester, United Kingdom; 3University of Birmingham, United Kingdom
Introduction: Our previous study has shown low rates of inpatient deintensification and high rates of adverse outcomes in people with diabetes and frailty1. The diabetes in reach (DiR) team consists of diabetologists working together with diabetes specialist nurses, proactively supporting non-specialists in the inpatient management of diabetes. This could be done either virtually or by face-to-face review in the medical ward. This study assessed the role of the DiR team in improving care for inpatients with diabetes and frailty.
Methods: We included all people with diabetes and clinical frailty score ≥ 6 discharged from our medical unit in the year of 2022. Data including demographics, medications and comorbidities were collected. Inpatient management and outcomes collected include involvement of the DiR team, deintensification rate, inpatient hypoglycaemia (defined by any episode of capillary blood glucose of <4 mmol/l), inpatient mortality and one-month readmission rates. Logistic regressions were conduction to assess for the association between the involvement of DiR with deintensification and other outcomes using StataSE v17.0.
Results: Six hundred and sixty-five people with diabetes and frailty were included in our analysis. 51.9% (n=345/665) were female with a median age of 79 years (71-86). 19% (n=119/625) were deintensified during admission. DiR teams were involved in the care of 26.8% (n=178/665) of the patients. People with inpatient hypoglycaemia were more likely to be reviewed by the DiR team compared to those without hypoglycaemia [aOR: 5.7 (95% CI: 3.7-8.6), P<0.001]. In patients who were deintensified, deintensification was done by the parent team in 38.7% (n=46/119) and 61.3% (n=73/119) by the DiR team. Irrespective of hypoglycaemia, being reviewed by the DiR team was associated with increased odds of deintensification compared to those that were not reviewed by the DiR team [aOR: 4.2 (95% CI: 2.6-6.8), P<0.001]. No associations were seen between being reviewed by DiR with inpatient mortality and readmission rate.
Conclusion: The majority of inpatient deintensification in people with diabetes and frailty was initiated by the DiR team, compared to the parent team. DiR could play an effective and important role in improving the inpatient deintensification rate in people with diabetes and frailty.
References: Melson E, Fazil M, Davitadze M, et al. Characteristics of patients admitted to the hospital with diabetes and clinical frailty: preliminary data of an audit in a
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more