通讯作者: 周强, zhouqiang8004@163.com

DOI：10.12201/bmr.202410.00016

Analysis of glycemic management among inpatients with diabetes in non-endocrinology department

• 摘要：目的 评价某院非内分泌科住院糖尿病患者血糖管理现状,发现血糖管理方面存在的问题,为血糖管理策略改进提供依据。方法 纳入2022年1月1日至2022年12月31日在非内分泌科住院且出院诊断包含糖尿病的成人患者。收集患者的病案首页、医嘱、实验室检测信息、床边血糖监测数据等。计算非内分泌科糖尿病患者检出率及血糖管理过程指标,包括糖化血红蛋白(HbA1c)检测率、空腹血糖(FBG)检测率、糖尿病饮食医嘱开具率及会诊率等。采用population模型、patient模型、patient-day模型,结合血糖管理结果指标包括目标范围血糖比例、高血糖和低血糖发生率评价血糖管理结局。比较手术患者和非手术患者在过程指标和结果指标方面的差异。结果 住院糖尿病患者中,91.32%分布在非内分泌科。非内分泌科糖尿病患者检出率为11.83%,HbA1c检测率为60.29%,FBG检测率为89.91%,末梢血糖监测率为88.85%,糖尿病饮食医嘱开具率85.59%,会诊率为31.21%。手术组HbA1c检测率低于非手术组,FBG检测率、糖尿病饮食医嘱开具率高于非手术组,差异均具有统计学意义(P＜0.001)。三种模型的目标范围血糖、严重高血糖、低血糖进行比较,差异均具有统计学意义(P＜0.001)。在population模型和patient-day模型中,手术组的目标范围血糖比例高于非手术组,严重高血糖发生率低于非手术组,差异具有统计学意义(P＜0.001)。结论 非内分泌科糖尿病检出率较高。手术与非手术患者在血糖管理质量指标方面存在差异。有必要进行全院血糖管理,提高非内分泌科血糖管理质量及管理的同质性。

  关键词： 糖尿病； 住院患者； 血糖管理；非内分泌科; ; ; 

   

  Abstract: Objective To assess the glycemic management of inpatients with diabetes in non-endocrinology department and discover the problems, so as to provide basis for the improvement of glycemic management. Methods　The inpatients diagnosed with diabetes in non-endocrine department from January 1, 2022 to December 31, 2022 were selected. The first page of medical records, doctors advices, laboratory test, and blood glucose monitoring data were collected. The detection rate and process indexes of glycemic management (detection rate of HbA1c, FBG, peripheral blood glucose test, diabetes-related dietary advices and consultation) in non-endocrine department were calculated. Three models of population, patient and patient-day model were used to evaluate the outcome of glycemic management, combined with the incidence of ideal blood glucose, hyperglycemia and hypoglycemia. The differences of process and outcome indicators between surgical and non-surgical patients were compared. Results 91.23% of inpatients with diabetes were in non-endocrinology department. The total detection rate of diabetes in non-endocrinology was 11.83%. The detection rate of HbA1c, FBG, peripheral blood glucose was 60.29%, 89.91% and 88.85%, respectively. 85.59% of patients had diabetes-related dietary advices, and 31.21% of the patients had consultations. The detection rate of HbA1c in surgical group was lower than that in non-surgical group (P < 0.001). The rate of FBG test and diabetes-related dietary advices in surgical group were higher than that in non-surgical group (P < 0.001). The rate of ideal blood glucose, severe hyperglycemia and hypoglycemia differed significantly across the three models (P < 0.001). In the population and patient-day model, the rate of ideal blood glucose in the surgical group was higher than that in the non-surgical group (P < 0.001), and the incidence of severe hyperglycemia in the surgical group was lower than that in the non-surgical group (P < 0.001). Conclusion The detection rate of inpatients with diabetes in non-endocrinology department was high. There are differences between surgical and non- surgical patients in quality indicators of glycemic management. It is necessary to carry out hospital-wide glycemic management to improve the quality and homogeneity of glycemic management.

  Key words: Diabetes; Inpatients; Glycemic management; Non-endocrinology

  提交时间：2024-10-08

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• 序号	提交日期	编号	操作
  1	2024-09-12	bmr.202410.00016V1	下载

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