Effects of counseling and implementation of clinical pathway on diabetic patients hospitalized with hypoglycemia

Abstract

Objectives: A prospective randomized controlled study was conducted to examine the effects of counseling and implementation of clinical pathway on type 2 diabetic patients hospitalized with hypoglycemia.

Material and method: Thirty- three cases received counseling and clinical pathway for treatment of hypoglycemia (study group) and another 32 cases received conventional treatment for hypoglycemia (control group) in Taksin Hospital between July and December 2005.

Results: Both groups have similar age, sex, and mean serum glucose on admission. There were also no differences between the two groups in terms of number of patients with chronic diabetic complications, acute concurrent illness and pattern of hypoglycemic drugs used for treatment. Average length of hospital stay of the study group was significantly lower than that of the control group (3.94 +/- 1.03 vs 6.38 +/- 4.05; p = 0.0005). There were also a significant decrease in the mean number of capillary blood glucose tests performed in the study group compared to the control group (10.03 +/- 5.04 vs 12.34 +/- 5.96; p = 0.048). Subsequent readmissions with recurrent hypoglycemia at 1 and 3 months interval after being discharged from the hospital decreased significantly in the study group (6.06 % vs 34.38 %; p = 0.036). While there was considerable reduction in mean medical cost in the study group, it did not reached a statistically significant difference when compared with the control group (2,743.58 +/- 1,473.04 vs 3,687 +/- 3,110.82; p = 0.06).

Conclusion: Counseling and implementation of clinical pathway on type 2 diabetic patients hospitalized with hypoglycemia can reduce the length of hospital stay and decrease readmission rates of recurrent hypoglycemia. This results in considerable health and economic benefits.