Efectividad y seguridad de un modelo protocolizado de control glucémico en el medio hospitalario

Objective

To evaluate the effectiveness and safety of a glucose control protocol designed to manage patients with diabetes in hospital.

Material and methods

An interventional, prospective and open study was designed for patients with diabetes admitted in a conventional hospital setting. Patients were randomized to an intervention group (glucose control protocol) or to a control group (conventional treatment for diabetes). Blood glucose was performed every 48 hours. The primary endpoint was to obtain a pre-prandial blood glucose between 80 and 180 mg/dl, and the secondary endpoint was the absence of hypoglycemia.

Results

The study included a total of 104 patients (51.0% male), with a mean age of 67.8 ± 9.2 years old, 13.7 ± 10.2 years since onset of diabetes, and mean HbA1c of 7.8 ± 1.5%. The patients in the intervention group showed a significant improvement in glucose control before all meals as well as in the 24 hour mean compared to day 0 and with the control group. In the first week, patients achieved a mean blood glucose of 148.2 ± 30.3 mg/dl. The percentage of patients with blood glucose between 80 and 180 mg/dl gradually increased, exceeding 50% of patients from day 4 for fasting blood glucose, day 5 for blood glucose before lunch, and day 7 for blood glucose before dinner. Seven patients (13.4%) had mild hypoglycemia in the intervention group, and nine (17.3%) in the control group (P=.817).

Conclusions

The use of a blood glucose control protocol in hospital settings is effective for improving metabolic control and to achieve the targets, with a low rate of associated hypoglycemia.