Trends in glycemic control over a 2-year period in 126 US hospitals

BACKGROUND Cross‐sectional data on inpatient glucose control in a large sample of US hospitals are now available, but little is known about changes in glycemic control over time in these institutions. OBJECTIVE To evaluate trends in glycemic control in US hospitals over 2 years. DESIGN Retrospective analysis. METHODS Point‐of‐care blood glucose (POC‐BG) test results at 126 hospitals during January to December 2007 and January to December 2009 were extracted using the Remote Automated Laboratory System‐Plus (Medical Automation Systems, Charlottesville, VA), and patient‐day‐weighted mean glucose levels were compared. SETTING/PATIENTS Hospitalized patients. RESULTS A total of 12,541,929 POC‐BG measurements from 1,010,705 patients were analyzed for 2007, and 10,659,418 POC‐BG measurements from 656,206 patients were analyzed for 2009. Patient‐day‐weighted mean POC‐BG in 2009 decreased by 5 mg/dL in the non‐intensive care unit (non‐ICU) data compared with that in 2007 (154 mg/dL vs 159 mg/dL, respectively; P < 0.001). However, POC‐BG values were clinically unchanged in intensive care unit (ICU) data from 2009 vs 2007 (167 mg/dL vs 166 mg/dL; P < 0.001). From 2007 to 2009, the proportion of patient‐day‐weighted mean POC‐BGs that were >180 mg/dL declined from 28% to 25% in non‐ICU patients (P < 0.001), but not in ICU. Decreases in patient‐day‐weighted mean POC‐BG values in non‐ICU patients were significant regardless of hospital size, type, and geographic region (all P < 0.001), but similar decreases were not found in ICU data. CONCLUSIONS In this first analysis of glucose changes in US hospitals, improvements over 2 years occurred in non‐ICU patients. Ongoing analysis will determine whether this trend continues. Journal of Hospital Medicine 2013;8:121–125. © 2012 Society of Hospital Medicine