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Impact of Hyperglycemia Education on Blood Glucose Control
Friday April 25, 2025 10:20am - 10:35am EDT
Parthenon 1
Title: Impact of Hyperglycemia Education on Blood Glucose Control
Authors: Maegan Huebner, Kaitlyn Claybrook, Martina Goings, Danna Nelson 
Objective: To evaluate the impact of provider hyperglycemia management education at Baptist Medical Center South through its effect on inpatient glucose control. 
Background: Hyperglycemia in hospitalized patients, defined as a serum blood glucose level greater than 140 mg/dL, is a common occurrence in acutely ill patients. The American Diabetes Association (ADA) currently recommends the use of insulin as the preferred treatment for hyperglycemia in the inpatient setting. Basal or basal plus bolus regimens are preferred, while prolonged sliding scale as sole hyperglycemia treatment is not recommended. Recommendations for maintaining blood glucose less than 180 mg/dL and tailoring insulin regimens around patient enteral intake can improve outcomes, shorten patient length of stay, and reduce readmission rates. To increase adherence to ADA guidelines, physician groups including family medical residents, general medicine residents, and hospitalists from Baptist Medical Center South received a 30 minute interactive presentation on hyperglycemia management.
Methods: This is a retrospective chart review of pre and post physician education for patients who had an order for sliding scale insulin and a serum blood glucose level greater than 200 mg/dL. Patients excluded were those less than 19 years old, prisoners, patients with a singular increased blood glucose level, patients admitted for diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), patients with an insulin pump, those requiring a continuous insulin infusion, and pregnancy. Pre-education data was collected and analyzed in June 2024 and post-education data was collected and analyzed in October 2024. Information collected on the selected patients included demographics, length of stay, ordering physician, blood glucose levels, hypoglycemia events, A1c, insulin regimens while hospitalized, and any other oral anti-diabetic medications used. 
Results: After randomization, a total of 40 pre-implementation patients and 75 post-implementation
patients were reviewed and included. For the pre-implementation group, the average length of stay was 14.01 days, 25% experienced a hypoglycemia event, and the average blood glucose was 189.7 mg/dL. The average starting dose for insulin glargine was 10 units per day. The amount of time blood glucose levels were >200 mg/dL was 39.8%. For the post-implementation group, the average length of stay was 17.03 days, 36% experienced a hypoglycemia event, and the average blood glucose was 176.2 mg/dL. The amount of time blood glucose levels were >200 mg/dL was 28.9%. The average starting dose for insulin glargine was 17 units per day. All patients had a sliding scale insulin order besides one patient in the post-implementation group. The most common sliding scale order was written for level 1. 
 
Conclusion: The post-implementation group demonstrated a reduction in the time blood glucose levels were greater than 200 mg/dL, but higher rates of hypoglycemia were also observed. These effects may have been impacted by differences among the study group numbers and patient demographics. The post-implementation group was observed to receive a higher average starting dose of insulin glargine. Providing guideline-based hyperglycemia education to physicians resulted in improved blood glucose control but did not significantly impact hospital length of stay.
 
Moderators
avatar for Matt Conley

Matt Conley

Pharmacy Informatics Specialist, AdventHealth
Presenters
MH

Maegan Huebner

PGY-1 Pharmacy Resident, Baptist Medical Center South
Maegan Huebner, PharmD is from Montgomery, AL and received her B.S in       Nutrition Wellness at Auburn University in 2020. She received her Doctor of    Pharmacy at Auburn University Harrison College of Pharmacy in 2024. She is a current resident at Baptist Medical Center... Read More →
Evaluators
EM
Friday April 25, 2025 10:20am - 10:35am EDT
Parthenon 1
  Internal Medicine (IM), Baptist Medical Center South
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