Management Status Of Adult Inpatients With Abnormal Blood Glucose In Non-endocrinology Department

Objective: To investigate the blood glucose management of adult inpatients with abnormal blood glucose in the non-endocrinology department in order to further improve the blood glucose management in the hospital.Methods: Patients with fasting blood glucose(FBG)?5.6mmol/L and postprandial blood glucose(PBG)or random blood glucose ? 7.8mmol/L during hospitalization discharged from the hospital from August 2018 to October 2018 were enrolled in.Medical history,blood glucose monitoring data,the process index(detection rate of FBG,PBG and glycated hemoglobin(HbA1c),average daily blood glucose monitoring frequency(BGMF),the rate of endocrine consultation,the rate of discharge diagnosis,the rate of discharge notification)and the outcome index(average blood glucose in-hospital,the rate of discharge blood glucose meeting the standard,the incidence of hyperglycemia and hypoglycemia in Population,Patient and Patient-day model)were collected and analyzed.Furthermore,the influencing factors on the rate of discharge blood glucose meeting the standard,the length of stay and the cost of the inpatients of non-endocrinology department with abnormal blood glucose were analyzed.Results: There were 3993 non-endocrinology inpatients,and the detection rate of abnormal blood glucose was 17.73%(708 inpatients).The detection rate of FBG(63.84%),PBG(76.13%)and HbA1c(36.3%),the rate of discharge diagnosis(54.66%),discharge notification(35.59%),the incidence of hyperglycemia in Population model(35.67%),the rate of discharge blood glucose meeting the standard(35.45%)in non-endocrinology(708 inpatients)were lower than that in endocrinology(177 inpatients)FBG(97.74%),PBG(98.31%)and HbA1c(85.88%),the rate of discharge diagnosis(96.05%),discharge notification(96.05%),the incidence of hyperglycemia in Population model(46.29%)and the rate of discharge blood glucose meeting the standard(62.71%)(P< 0.05,respectively).Among the patients with abnormal blood glucose in non-endocrinology department,the detection rate of PBG(79.76%)and HbA1c(48.67%),the rate of discharge diagnosis(60.96%),discharge notification(48.92%)and the incidence of hyperglycemia in Population model(36.71%)in internal medicine were higher than that in surgery PBG(70.99%),HbA1c(22.18%),discharge diagnosis(46.08%),discharge notification(16.72%)and the incidence of hyperglycemia in Population model(34.28%)(P< 0.05,respectively).The BGMF(1.42 ± 1.38)times/day,the rate of discharge diagnosis(58.54%),discharge notification(45.37%)and discharge blood glucose meeting the standard(38.54%)of nonoperative department inpatients were higher than that in surgery department inpatients BGMF(1.19± 1.13)times/day,the rate of discharge diagnosis(49.33%),discharge notification(22.15%)and discharge blood glucose meeting the standard(31.21%)(P< 0.05,respectively).The detection rate of FBG(85.79%),PBG(93.28%)and HbA1c(93.28%),the incidence of hyperglycemia in Population model(41.02%)and the rate of discharge blood glucose meeting the standard(49.61%)of diagnosed inpatients were higher than that in undiagnosed inpatients FBG(37.38%),PBG(55.45%)and HbA1c(21.81%),the incidence of hyperglycemia in Population model(20.41%)and the rate of discharge blood glucose meeting the standard(18.38%)(P< 0.05,respectively).The detection rate of FBG(90.63%),PBG(95.83%)and HbA1c(65.63%),the rate of discharge diagnosis(94.79%),discharge notification(71.88%)and the incidence of hyperglycemia in Population model(59.80%)of consulted inpatients were higher than that in unconsulted inpatients FBG(59.64%),PBG(73.04%)and HbA1c(33.33%),the rate of discharge diagnosis(48.37%),discharge notification(29.90%)and the incidence of hyperglycemia in Population model(28.00%)(P< 0.05,respectively).The frequency of daily blood glucose monitoring,age,seriously ill,and discharge diagnosis were factors which can affect discharge blood glucose of inpatients in non-endocrinology(P< 0.05).The length of stay of inpatients with appropriate discharge blood glucose level(16.07±10.82)days was longer than that of inpatients with substandard blood glucose level(13.94±9.52)days(P< 0.05).However,there wasno significant difference between the hospitalization expenses of inpatients with appropriate blood glucose level(23150.31 ± 24753.11)yuan and with substandard blood glucose level(21907.66±27393.07)yuan(P> 0.05).Conclusion: Non-endocrinologists had not done enough to monitor and manage the blood glucose of inpatients with abnormal blood glucose and they also needed to pay attention to the blood glucose management of non-elderly,non-critically ill and non-diabetic patients,so as to improve the quality of blood glucose management of the whole hospital.