Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Aug;211(4):175-180.
doi: 10.5694/mja2.50247. Epub 2019 Jun 23.

Glucometric benchmarking in an Australian hospital enabled by networked glucose meter technology

Mervyn Kyi  1   2 , Peter G Colman  1 , Lois M Rowan  1 , Katie A Marley  1 , Paul R Wraight  1 , Spiros Fourlanos  1   2
Affiliations
Observational Study

Glucometric benchmarking in an Australian hospital enabled by networked glucose meter technology

Mervyn Kyi et al. Med J Aust. 2019 Aug.

Abstract

Objective: To assess glucometric outcomes and to estimate the incidence of hypo- and hyperglycaemia among non-critical care inpatients in a major Australian hospital.

Design, setting and participants: A prospective 10-week observational study (7 March - 22 May 2016) of consecutive inpatients with diabetes or newly detected hyperglycaemia admitted to eight medical and surgical wards at the Royal Melbourne Hospital. Point-of-care blood glucose (BG) data were collected with networked glucose meters.

Main outcome measures: Glycaemic control, as assessed with three glucometric models (by population, by patient, by patient-day); incidence of adverse glycaemic days (AGDs; patient-days with BG levels below 4 mmol/L or above 15 mmol/L).

Results: During the study period, there were 465 consecutive admissions of 441 patients with diabetes or newly detected hyperglycaemia, and 9817 BG measurements over 2953 patient-days. The mean patient-day BG level was 9.5 mmol/L (SD, 3.3 mmol/L). The incidence of hyperglycaemia was higher than for a United States hospital benchmark (patient-days with mean BG level above 10 mmol/L, 37% v 32), and that of hypoglycaemia lower (proportion of patient-days with mean BG level below 3.9 mmol/L, 4.1% v 6.1%). There were 260 (95% CI, 245-277) AGDs per 1000 patient-days; the incidence was higher in medical than surgical ward patients (290 [CI, 270-310] v 206 [CI, 181-230] per 1000 patient-days). 604 AGDs (79%) were linked with 116 patients (25%). Episodes of hyperglycaemia (BG above 15 mmol/L) were more frequent before lunch, dinner, and bedtime; 94 of 187 episodes of hypoglycaemia (BG below 4 mmol/L) occurred between 11 pm and 8 am.

Discussion: Glucometric analysis supported by networked glucose meter technology provides detailed inpatient data that could enable local benchmarking for promoting safe diabetes care in Australian hospitals.

Keywords: Diabetes mellitus, type 1; Diabetes mellitus, type 2; Health services research; Hospitals; Technology.

PubMed Disclaimer

References

    1. Australian Institute of Health and Welfare. Australia's health 2016 (Cat. No. AUS 199; Australia's Health series no. 15). Canberra: AIHW, 2016.
    1. Magliano DJ, Peeters A, Vos T, et al. Projecting the burden of diabetes in Australia: what is the size of the matter? Aust N Z J Public Health 2009; 33: 540-543.
    1. Jiang HJ, Stryer D, Friedman B, et al. Multiple hospitalizations for patients with diabetes. Diabetes Care 2003; 26: 1421-1426.
    1. Bach LA, Ekinci EI, Engler D, et al. The high burden of inpatient diabetes mellitus: the Melbourne Public Hospitals Diabetes Inpatient Audit. Med J Aust 2014; 201: 334-338. https://www.mja.com.au/journal/2014/201/6/high-burden-inpatient-diabetes....
    1. Nanayakkara N, Nguyen H, Churilov L, et al. Inpatient HbA1c testing: a prospective observational study. BMJ Open Diabetes Res Care 2015; 3: e000113.

Publication types

MeSH terms

LinkOut - more resources