High Glucose Variability in Hospitalized Patients with Type 1 Diabetes Mellitus

Vikash Dadlani, Shrikant U. Tamhane, Aidong Sun, Anu Sharma, Danae A. Delivanis, Prabin Thapa, Rickey E. Carter, Yogish C Kudva

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. Materials and Methods: Retrospective single center cohort study, we analyzed in-hospital glucose measurements to assess GV in 736 hospitalized patients in different units over a consecutive 5-year period of time. GV was assessed by mean blood glucose (BG), Average daily risk range (ADRR), high BG index, and low BG index. To place our findings in context, we conducted a systematic review using Cochrane collaboration methodology to critically analyze current published literature on GV in hospitalized T1D patients. Results: Overall, glycemic control was suboptimal with mean BG 183 ± 51.5 mg/dL and mean ADRR 35 with only 16% patients being categorized as low risk (ADRR <20) for hypo or hyperglycemia. Patients admitted in medical units had mean BG of 194.4 ± 42.8 mg/dL (95% CI = 101.2-346.6) and ADRR of 39.4 ± 16 (95% CI = 1.3-118.7), which were higher than the patients admitted in the surgical units (mean BG 168.1 ± 35.7 (95% CI = 74.8-301.8) and mean ADRR (28.8 ± 13.1 [95% CI = 0.3-93.1]). For the systematic review initial search yielded 2336 studies for screening, however, none of them had data specific for T1D. Conclusion: GV is high in hospitalized T1D patients admitted at our tertiary care center. Review of the literature shows paucity of data regarding GV in hospitalized patients with T1D.

Original languageEnglish (US)
Pages (from-to)572-579
Number of pages8
JournalDiabetes Technology and Therapeutics
Volume19
Issue number10
DOIs
StatePublished - Oct 1 2017

Fingerprint

Type 1 Diabetes Mellitus
Glucose
Blood Glucose
Tertiary Care Centers
Hyperglycemia
Cohort Studies

Keywords

  • Glucose variability
  • Hospitalization
  • Hyperglycemia
  • Hypoglycemia
  • Type 1 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Medical Laboratory Technology

Cite this

High Glucose Variability in Hospitalized Patients with Type 1 Diabetes Mellitus. / Dadlani, Vikash; Tamhane, Shrikant U.; Sun, Aidong; Sharma, Anu; Delivanis, Danae A.; Thapa, Prabin; Carter, Rickey E.; Kudva, Yogish C.

In: Diabetes Technology and Therapeutics, Vol. 19, No. 10, 01.10.2017, p. 572-579.

Research output: Contribution to journalArticle

Dadlani, Vikash ; Tamhane, Shrikant U. ; Sun, Aidong ; Sharma, Anu ; Delivanis, Danae A. ; Thapa, Prabin ; Carter, Rickey E. ; Kudva, Yogish C. / High Glucose Variability in Hospitalized Patients with Type 1 Diabetes Mellitus. In: Diabetes Technology and Therapeutics. 2017 ; Vol. 19, No. 10. pp. 572-579.
@article{9628e78a403e478bae9d727749ab6f1d,
title = "High Glucose Variability in Hospitalized Patients with Type 1 Diabetes Mellitus",
abstract = "Background: Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. Materials and Methods: Retrospective single center cohort study, we analyzed in-hospital glucose measurements to assess GV in 736 hospitalized patients in different units over a consecutive 5-year period of time. GV was assessed by mean blood glucose (BG), Average daily risk range (ADRR), high BG index, and low BG index. To place our findings in context, we conducted a systematic review using Cochrane collaboration methodology to critically analyze current published literature on GV in hospitalized T1D patients. Results: Overall, glycemic control was suboptimal with mean BG 183 ± 51.5 mg/dL and mean ADRR 35 with only 16{\%} patients being categorized as low risk (ADRR <20) for hypo or hyperglycemia. Patients admitted in medical units had mean BG of 194.4 ± 42.8 mg/dL (95{\%} CI = 101.2-346.6) and ADRR of 39.4 ± 16 (95{\%} CI = 1.3-118.7), which were higher than the patients admitted in the surgical units (mean BG 168.1 ± 35.7 (95{\%} CI = 74.8-301.8) and mean ADRR (28.8 ± 13.1 [95{\%} CI = 0.3-93.1]). For the systematic review initial search yielded 2336 studies for screening, however, none of them had data specific for T1D. Conclusion: GV is high in hospitalized T1D patients admitted at our tertiary care center. Review of the literature shows paucity of data regarding GV in hospitalized patients with T1D.",
keywords = "Glucose variability, Hospitalization, Hyperglycemia, Hypoglycemia, Type 1 diabetes",
author = "Vikash Dadlani and Tamhane, {Shrikant U.} and Aidong Sun and Anu Sharma and Delivanis, {Danae A.} and Prabin Thapa and Carter, {Rickey E.} and Kudva, {Yogish C}",
year = "2017",
month = "10",
day = "1",
doi = "10.1089/dia.2017.0107",
language = "English (US)",
volume = "19",
pages = "572--579",
journal = "Diabetes Technology and Therapeutics",
issn = "1520-9156",
publisher = "Mary Ann Liebert Inc.",
number = "10",

}

TY - JOUR

T1 - High Glucose Variability in Hospitalized Patients with Type 1 Diabetes Mellitus

AU - Dadlani, Vikash

AU - Tamhane, Shrikant U.

AU - Sun, Aidong

AU - Sharma, Anu

AU - Delivanis, Danae A.

AU - Thapa, Prabin

AU - Carter, Rickey E.

AU - Kudva, Yogish C

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background: Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. Materials and Methods: Retrospective single center cohort study, we analyzed in-hospital glucose measurements to assess GV in 736 hospitalized patients in different units over a consecutive 5-year period of time. GV was assessed by mean blood glucose (BG), Average daily risk range (ADRR), high BG index, and low BG index. To place our findings in context, we conducted a systematic review using Cochrane collaboration methodology to critically analyze current published literature on GV in hospitalized T1D patients. Results: Overall, glycemic control was suboptimal with mean BG 183 ± 51.5 mg/dL and mean ADRR 35 with only 16% patients being categorized as low risk (ADRR <20) for hypo or hyperglycemia. Patients admitted in medical units had mean BG of 194.4 ± 42.8 mg/dL (95% CI = 101.2-346.6) and ADRR of 39.4 ± 16 (95% CI = 1.3-118.7), which were higher than the patients admitted in the surgical units (mean BG 168.1 ± 35.7 (95% CI = 74.8-301.8) and mean ADRR (28.8 ± 13.1 [95% CI = 0.3-93.1]). For the systematic review initial search yielded 2336 studies for screening, however, none of them had data specific for T1D. Conclusion: GV is high in hospitalized T1D patients admitted at our tertiary care center. Review of the literature shows paucity of data regarding GV in hospitalized patients with T1D.

AB - Background: Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. Materials and Methods: Retrospective single center cohort study, we analyzed in-hospital glucose measurements to assess GV in 736 hospitalized patients in different units over a consecutive 5-year period of time. GV was assessed by mean blood glucose (BG), Average daily risk range (ADRR), high BG index, and low BG index. To place our findings in context, we conducted a systematic review using Cochrane collaboration methodology to critically analyze current published literature on GV in hospitalized T1D patients. Results: Overall, glycemic control was suboptimal with mean BG 183 ± 51.5 mg/dL and mean ADRR 35 with only 16% patients being categorized as low risk (ADRR <20) for hypo or hyperglycemia. Patients admitted in medical units had mean BG of 194.4 ± 42.8 mg/dL (95% CI = 101.2-346.6) and ADRR of 39.4 ± 16 (95% CI = 1.3-118.7), which were higher than the patients admitted in the surgical units (mean BG 168.1 ± 35.7 (95% CI = 74.8-301.8) and mean ADRR (28.8 ± 13.1 [95% CI = 0.3-93.1]). For the systematic review initial search yielded 2336 studies for screening, however, none of them had data specific for T1D. Conclusion: GV is high in hospitalized T1D patients admitted at our tertiary care center. Review of the literature shows paucity of data regarding GV in hospitalized patients with T1D.

KW - Glucose variability

KW - Hospitalization

KW - Hyperglycemia

KW - Hypoglycemia

KW - Type 1 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85031795113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031795113&partnerID=8YFLogxK

U2 - 10.1089/dia.2017.0107

DO - 10.1089/dia.2017.0107

M3 - Article

C2 - 29045170

AN - SCOPUS:85031795113

VL - 19

SP - 572

EP - 579

JO - Diabetes Technology and Therapeutics

JF - Diabetes Technology and Therapeutics

SN - 1520-9156

IS - 10

ER -