Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation

Elizabeth M Lamos,1 Marniker A Wijesinha,2 Seba Ramhmdani,1 Laurence S Magder,2 Kristi D Silver1 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD, USA Objective: To compare length of stay (LOS) and inc...

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Autores principales:	Lamos EM, Wijesinha MA, Ramhmdani S, Magder LS, Silver KD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	diabetes mellitus renal transplantation length of stay hypoglycemia infection Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/c007a9fb4c794bae907688bf52b3427b
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spelling	oai:doaj.org-article:c007a9fb4c794bae907688bf52b3427b2021-12-02T08:06:54ZRole of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation1178-7007https://doaj.org/article/c007a9fb4c794bae907688bf52b3427b2017-01-01T00:00:00Zhttps://www.dovepress.com/role-of-glycemic-control-on-hospital-related-outcomes-in-patients-with-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Elizabeth M Lamos,1 Marniker A Wijesinha,2 Seba Ramhmdani,1 Laurence S Magder,2 Kristi D Silver1 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD, USA Objective: To compare length of stay (LOS) and incidence of hypoglycemic events and infections in hospitalized patients with diabetes mellitus (DM) undergoing renal transplantation, among groups of patients defined by admission glucose and mean inpatient daily glucose. Methods: A retrospective analysis of 190 charts of patients with DM who underwent renal transplantation over a 2-year period was conducted. Patients were grouped according to admission glucose and mean inpatient daily glucose (≤140 mg/dL, 141–180 mg/dL, and >180 mg/dL). Results: Admission glucose was not associated with LOS. A mean inpatient daily glucose of ≤140 mg/dL was associated with a longer LOS compared to a mean inpatient daily glucose of >180 mg/dL (p=0.03). Patients with an admission glucose of ≤140 mg/dL had approximately half the rate of hypoglycemic events compared to those with admission glucose of 141−180 mg/dL (odds ratio [OR]=2.1; p=0.02) or >180 mg/dL (OR=1.9; p=0.04). However, patients whose mean daily glucose was ≤140 mg/dL had approximately twice the rate of hypoglycemic events than those whose mean daily glucose was 141−180 mg/dL (OR=0.4; p=0.01) or >180 mg/dL (OR=0.4; p=0.004). The incidence of infections was low and was not associated with admission or mean daily glucose levels. Conclusion: Lower mean daily inpatient glucose levels (≤140 mg/dL) are associated with longer LOS and greater incidence of hypoglycemic episodes in diabetes patients undergoing renal transplantation. Our findings suggest that target blood glucose levels of 140−180 mg/dL may be appropriate in this specific population. Additional prospective research is needed to confirm these findings. Keywords: diabetes mellitus, renal transplantation, length of stay, hypoglycemia, infectionLamos EMWijesinha MARamhmdani SMagder LSSilver KDDove Medical Pressarticlediabetes mellitusrenal transplantationlength of stayhypoglycemiainfectionSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 10, Pp 13-17 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes mellitus renal transplantation length of stay hypoglycemia infection Specialties of internal medicine RC581-951
spellingShingle	diabetes mellitus renal transplantation length of stay hypoglycemia infection Specialties of internal medicine RC581-951 Lamos EM Wijesinha MA Ramhmdani S Magder LS Silver KD Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
description	Elizabeth M Lamos,1 Marniker A Wijesinha,2 Seba Ramhmdani,1 Laurence S Magder,2 Kristi D Silver1 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD, USA Objective: To compare length of stay (LOS) and incidence of hypoglycemic events and infections in hospitalized patients with diabetes mellitus (DM) undergoing renal transplantation, among groups of patients defined by admission glucose and mean inpatient daily glucose. Methods: A retrospective analysis of 190 charts of patients with DM who underwent renal transplantation over a 2-year period was conducted. Patients were grouped according to admission glucose and mean inpatient daily glucose (≤140 mg/dL, 141–180 mg/dL, and >180 mg/dL). Results: Admission glucose was not associated with LOS. A mean inpatient daily glucose of ≤140 mg/dL was associated with a longer LOS compared to a mean inpatient daily glucose of >180 mg/dL (p=0.03). Patients with an admission glucose of ≤140 mg/dL had approximately half the rate of hypoglycemic events compared to those with admission glucose of 141−180 mg/dL (odds ratio [OR]=2.1; p=0.02) or >180 mg/dL (OR=1.9; p=0.04). However, patients whose mean daily glucose was ≤140 mg/dL had approximately twice the rate of hypoglycemic events than those whose mean daily glucose was 141−180 mg/dL (OR=0.4; p=0.01) or >180 mg/dL (OR=0.4; p=0.004). The incidence of infections was low and was not associated with admission or mean daily glucose levels. Conclusion: Lower mean daily inpatient glucose levels (≤140 mg/dL) are associated with longer LOS and greater incidence of hypoglycemic episodes in diabetes patients undergoing renal transplantation. Our findings suggest that target blood glucose levels of 140−180 mg/dL may be appropriate in this specific population. Additional prospective research is needed to confirm these findings. Keywords: diabetes mellitus, renal transplantation, length of stay, hypoglycemia, infection
format	article
author	Lamos EM Wijesinha MA Ramhmdani S Magder LS Silver KD
author_facet	Lamos EM Wijesinha MA Ramhmdani S Magder LS Silver KD
author_sort	Lamos EM
title	Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
title_short	Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
title_full	Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
title_fullStr	Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
title_full_unstemmed	Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
title_sort	role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c007a9fb4c794bae907688bf52b3427b
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Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation

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