Continuous glucose monitoring identifies relationship between optimized glycemic control and post-discharge acute care facility needs
2018
Hyperglycemia is an independent risk factor in hospitalized patients for adverse outcomes, even if patients are not diabetic. We used continuous glucose monitoring to evaluate whether
glycemiccontrol (hyperglycemia) in the first 72 h after an intensive care admission was associated with the need for admission to a post discharge long-term medical facility. We enrolled 59 coronary artery bypass grafting patients. Poor
glycemiccontrol was defined as greater than 33% of continuous glucose monitoring values 180 mg/dL (group 1); and then these patients were reevaluated with a less strict definition of poor
glycemiccontrol with greater than 25% of continuous glucose values 180 mg/dL (group 2). In group 1 4/10 (40.0%) whose glucose was not
well controlledwent to an extended care post discharge facility as opposed to 6/49 (12.2%) that were
well controlled. In reevaluation as group 2, 5/14 (35.7%) whose glucose was not
well controlledwent to an extended care post discharge facility as opposed to 5/45 (11.1%) who were
well controlled. Admission to a post discharge facility was increased in patients with poor
glycemiccontrol p = 0.045 and p = 0.042 for group 1 and group 2, and with odds ratios of 4.8 (95% CI 1.0–22.5) and 4.4 (95% CI 1.0–19.4), respectively.
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