EFFECTS OF AN INTERVENTION BY A DIABETES TEAM IN HOSPITALIZED-PATIENTS WITH DIABETES

OBJECTIVE - Hospitalized patients with diabetes have a prolonged lengt h of stay in the hospital. We conducted a controlled prospective rando mized feasibility study of the effects of a diabetes team (a diabetes nurse educator and an endocrinologist) on the length of stay and other outcomes of hospitalization in these patients. RESEARCH DESIGN AND ME THODS - A total of 179 hospitalized patients with diabetes were random ly assigned to receive usual care supplemented with (85 patients) or w ithout (94 control patients) a diabetes team intervention. Outcome mea sures included the length of stay, blood glucose control, and rates of readmissions. RESULTS - For the primary diagnosis of diabetes, the me dian length of slay was 5.5 days (95% CI 4-8 days) for patients who re ceived diabetes team intervention and 7.5 days (5-11 days) for the con trol patients (NS). For the secondary diagnosis of diabetes, the media n length of stay was 10.0 days (8-13 days) in the intervention group a nd 10.5 days (8-13 days) in the control group (NS). One month after th e team intervention was initialed, 75% of patients in the intervention group were in good glycemic control, compared with 46% in the control group. Readmissions at 3 months after discharge included 13 (15%) pat ients from the intervention group and 30 (32%) patients in the control group (P = 0.01). CONCLUSIONS - Randomized controlled prospective tri als of clinical interventions in hospitalized patients with diabetes a re feasible. Diabetes team intervention appears to reduce the hospital length of stay and to improve glycemic control. Team intervention sig nificantly reduces the rate of recurrent hospitalization.