Background:
Glucometrics is a way to measure the success of inpatient glucose management and consists of measures of Glycaemic exposure; Efficacy of Control; Rate of adverse events, particularly hypoglycaemia.
Approximately a third of inpatients have diabetes mellitus. Inpatient diabetes management is standardised within NALHN using a mealtime supplemental subcutaneous insulin protocol or intravenous insulin protocols. Until now there has been no attempt to assess glycaemic exposure on a hospital wide basis in our institution.
Aim:
To examine Glucometric data in inpatients admitted to NALHN to determine the proportion of capillary Blood Glucose Levels (BGLs):
- At glycaemic target: 7.0-10.0mmol/L (efficacy of Control);
- Greater than 10.0mmol/L;
- In a “safe” range: 3.9 - 10.0mmol/L;
- In a hypoglycaemic range: less than 3.9mmol/l
Methodology:
All hospital glucometers (Abbott Freestyle Optium) are identified by a unique serial number recorded in NALHN Diabetes Education Centre. We attempted to identify each of these glucometers to downloaded a 28 day snapshot of BGLs in December 2016 for analysis.
All wards except intensive care, high dependency, the emergency department and paediatric wards were included.
Average BGLs and glucometric data expressed as percentages will be presented collectively as Hospital wide data and also by inpatient location. Data will be interpreted in the context of existing inpatient diabetes management guidelines.
Results:
6702 BGLs were included in the analysis. Hospital wide average BGL was 8.6mmol/L. 31.1% of BGLs were at target. 28.2% of BGLs were above target. 68.9% of BGLs were in a safe range. 2.8% of BGLs were in a hypoglycaemic range. Data analysed by location will also be presented.
Conclusions:
The majority of BGLs measured in NAHLN inpatients were within a safe range, with a small percentage in a hypoglycaemic range. Analysis of BGLs by location can be used to identify at risk locations in hospital to target further diabetes management strategies and education.