1129-P: Effect of Discharge Day on Post-discharge Glycemic Control

Introduction & Objective: Hospital readmission rates are nearly two times higher in patients with diabetes. Risk of readmission for severe dysglycemia is sixfold higher in patients with a prior hospitalization for severe dysglycemia. The DIREMOS study aimed to assess the use of continuous glucose monitoring upon hospital discharge. This subanalysis compares glycemic metrics of patients discharged on weekdays versus weekends. Methods: Forty hospitalized patients with diabetes (type I, type II, steroid induced) who experienced inpatient dysglycemia were enrolled in a pilot feasibility study using a real time remote patient monitoring system for thirty days after hospital discharge. In this secondary analysis of thirty-nine participants (1 dropped), time in range (TIR) (70-180 mg/dl) and time with severe hyperglycemia (>250 mg/dL) for the three days post-discharge (day 0, 1, 2, 3) are compared in participants discharged on weekdays (Monday-Thursday) versus weekends (Friday-Sunday or holiday). Results: Twenty-five participants were discharged on weekdays, and 14 participants were discharged on weekends. Mean post-discharge TIR was 47.7±26% in the weekday group and 42.0±25% in the weekend group. Median time with severe hyperglycemia was 9% (IQR 2-28%) in the weekday group and 14% (IQR 9-36%) in the weekend group. Four (16%) of weekday and 3 (21%) of weekend participants reported difficulty with medication access. Conclusion: Three-day post-discharge average TIR was lower and time above 250 mg/dL was higher in participants discharged on weekends. This data suggests that weekend discharges have additional factors that negatively impact post-discharge glycemic control. More research and quality improvement initiatives are needed on the impact of weekday vs weekend discharges on glycemic control and the effect of time in range on readmission risk.