- Complications
- Differences in Clinical Outcomes between Patients with and without Hypoglycemia during Hospitalization: A Retrospective Study Using Real-World Evidence
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Jeongmin Lee, Tong Min Kim, Hyunah Kim, Seung-Hwan Lee, Jae Hyoung Cho, Hyunyong Lee, Hyeon Woo Yim, Kun-Ho Yoon, Hun-Sung Kim
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Diabetes Metab J. 2020;44(4):555-565. Published online May 8, 2020
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DOI: https://doi.org/10.4093/dmj.2019.0064
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- Background
Some patients admitted to hospitals for glycemic control experience hypoglycemia despite regular meals and despite adhering to standard blood glucose control protocols. Different factors can have a negative impact on blood glucose control and prognosis after discharge. This study investigated risk factors for hypoglycemia and its effects on glycemic control during the hospitalization of patients in the general ward. MethodsThis retrospective study included patients who were admitted between 2009 and 2018. Patients were provided regular meals at fixed times according to ideal body weights during hospitalization. We categorized the patients into two groups: those with and those without hypoglycemia during hospitalization. ResultsOf the 3,031 patients, 379 experienced at least one episode of hypoglycemia during hospitalization (HYPO group). Hypoglycemia occurred more frequently particularly in cases of premixed insulin therapy. Compared with the control group, the HYPO group was older (61.0±16.8 years vs. 59.1±16.5 years, P=0.035), with more females (60.4% vs. 49.6%, P<0.001), lower body mass index (BMI) (23.5±4.2 kg/m2 vs. 25.1±4.4 kg/m2, P<0.001), and higher prevalence of type 1 diabetes mellitus (6.1% vs. 2.6%, P<0.001), They had longer hospital stay (11.1±13.5 days vs. 7.6±4.6 days, P<0.001). After discharge the HYPO group had lower glycosylated hemoglobin reduction rate (−2.0%±0.2% vs. −2.5%±0.1%, P=0.003) and tended to have more frequent cases of cardiovascular disease. ConclusionHypoglycemia occurred more frequently in older female patients with lower BMI and was associated with longer hospital stay and poorer glycemic control after discharge. Therefore, clinicians must carefully ensure that patients do not experience hypoglycemia during hospitalization.
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Citations
Citations to this article as recorded by
- Hypoglycemia in hospitalized patients: A sleeping monster
Swarna Deepak Kuragayala, Sumita Nayak, Khalid Khatib Muller Journal of Medical Sciences and Research.2024; 15(1): 5. CrossRef - Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes
Ana Carreira, Pedro Castro, Filipe Mira, Miguel Melo, Pedro Ribeiro, Lèlita Santos Acta Diabetologica.2023; 60(9): 1179. CrossRef - Adherence to healthy lifestyle behaviors as a preventable risk factor for severe hypoglycemia in people with type 2 diabetes: A longitudinal nationwide cohort study
Jae‐Seung Yun, Kyungdo Han, Yong‐Moon Park, Eugene Han, Yong‐ho Lee, Seung‐Hyun Ko Journal of Diabetes Investigation.2022; 13(9): 1533. CrossRef - Predicting hypoglycemia in hospitalized patients with diabetes: A derivation and validation study
Michal Elbaz, Jeries Nashashibi, Shiri Kushnir, Leonard Leibovici Diabetes Research and Clinical Practice.2021; 171: 108611. CrossRef - Hospital care: improving outcomes in type 1 diabetes
Schafer Boeder, Kristen Kulasa Current Opinion in Endocrinology, Diabetes & Obesity.2021; 28(1): 14. CrossRef - Data Pseudonymization in a Range That Does Not Affect Data Quality: Correlation with the Degree of Participation of Clinicians
Soo-Yong Shin, Hun-Sung Kim Journal of Korean Medical Science.2021;[Epub] CrossRef - Letter: Differences in Clinical Outcomes between Patients with and without Hypoglycemia during Hospitalization: A Retrospective Study Using Real-World Evidence (Diabetes Metab J 2020;44:555-65)
Sung-Woo Kim Diabetes & Metabolism Journal.2020; 44(5): 775. CrossRef - Response: Differences in Clinical Outcomes between Patients with and without Hypoglycemia during Hospitalization: A Retrospective Study Using Real-World Evidence (Diabetes Metab J 2020;44:555-65)
Jeongmin Lee, Hun-Sung Kim Diabetes & Metabolism Journal.2020; 44(5): 779. CrossRef - Hypoglycaemia and Cardiovascular Disease Risk in Patients with Diabetes
Niki Katsiki, Kalliopi Kotsa, Anca P. Stoian, Dimitri P. Mikhailidis Current Pharmaceutical Design.2020; 26(43): 5637. CrossRef
- Clinical Care/Education
- Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
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Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
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Diabetes Metab J. 2017;41(3):187-194. Published online May 12, 2017
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DOI: https://doi.org/10.4093/dmj.2017.41.3.187
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5,093
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- Background
When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels. MethodsThe study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management. ResultsPatients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%±1.3% to 6.6%±0.9%, P=0.0092) and for 1 to 5 years (from 7.5%±1.8% to 6.9%±1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024). ConclusionFor patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.
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Citations
Citations to this article as recorded by
- Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim The Journal of Korean Diabetes.2022; 23(1): 64. CrossRef - Effect of Voluntary Participation on Mobile Health Care in Diabetes Management: Randomized Controlled Open-Label Trial
Da Young Lee, Seung-Hyun Yoo, Kyong Pil Min, Cheol-Young Park JMIR mHealth and uHealth.2020; 8(9): e19153. CrossRef - Developing a multi-center clinical data mart of ACEI and ARB for real-world evidence (RWE)
Hun-Sung Kim, Sue Hyun Lee, Tong Min Kim, Ju Han Kim Clinical Hypertension.2018;[Epub] CrossRef
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