Basal-bolus insulin therapy in postoperative inpatients with diabetes mellitus: directions for future quality-improvement initiatives

Future Sci OA. 2017 Oct 25;4(1):FSO256. doi: 10.4155/fsoa-2017-0099. eCollection 2018 Jan.

Abstract

Aim: To determine variables associated with hyperglycemia and insulin therapy in postoperative inpatients with diabetes mellitus following a quality-improvement initiative.

Materials & methods: Patients with diabetes mellitus following an elective surgical procedure (n = 782; 877 surgical procedures) were selected.

Results: Age, hemoglobin A1c corticosteroids, insulin therapy and year of surgery were associated (p < 0.01) with hyperglycemia. Hemoglobin A1c, hyperglycemia, case mix index and corticosteroids were associated (p ≤ 0.03) with insulin therapy. Hyperglycemia and use of insulin varied by surgical specialty.

Conclusion: Data could be used to modify current treatment algorithms. Variations in hyperglycemia and insulin use by surgical specialty require further investigation.

Keywords: endocrinology; metabolism; surgery.