Summary
Educational intervention to introduce an emergency department hyperglycemia treatment
Alcalde López S, Oliete Blanco MP, Usieto López L, Javierre Loris MA, Parrilla Herranz P, Povar Marco J
Affiliation of the authors
Servicio de Urgencias, Hospital Universitario Miguel Servet, Zaragoza, Spain.
DOI
Quote
Alcalde López S, Oliete Blanco MP, Usieto López L, Javierre Loris MA, Parrilla Herranz P, Povar Marco J. Educational intervention to introduce an emergency department hyperglycemia treatment. Emergencias. 2013;25:43-6
Summary
Objectives: To assess an emergency department (ED) educational intervention leading
to implementation of a hyperglycemia treatment protocol. Our hypothesis was that the
ED educational intervention would increase use of basal-bolus therapy for hospital
management of hyperglycemia.
Methods: Quasi-experimental pre-post intervention study comparing unmatched groups.
Patients treated before and after the intervention were selected consecutively. All were over the age of 18 years and admitted from the ED with a diagnosis of type-2 diabetes and a blood sugar level over 180 mg/dL. The variables analyzed were percentage of patients in
each group treated with basal-bolus therapy, and the degree of glycemic control (days until
blood sugar levels were brought under control, mean blood sugar levels, and number of
hyperglycemic [>180 mg/dL], and hypoglycemic [<60 mg/dL] episodes). Results: A total of 96 patients (preintervention, 45; postintervention, 51) were included. The use of basal-bolus therapy increased significantly after implementation of the protocol (preintervention, 22%; postintervention, 71%; P<.01). We saw no differences in the mean (SD) number of days until blood sugar levels were brought under control: 4.9 days vs 4.5 days in the pre- and postintervention groups, respectively (P=.43). Likewise, the percentages of patients achieving glycemic control by day 5 were similar in the 2 groups, at 51.6% and 56.8%, respectively; P=.65). Hypoglycemia tended to develop less often in the postintervention group (20% vs 7.5%, respectively) but the difference was not significant (P=.09). Conclusion: The educational intervention was effective in leading to the implementation of basal-bolus therapy for managing hyperglycemia.