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

Citation
Lamos, E. M., et al. “Role Of Glycemic Control On Hospital-Related Outcomes In Patients With Diabetes Mellitus Undergoing Renal Transplantation.”. Diabetes, Metabolic Syndrome And Obesity : Targets And Therapy, pp. 13-17.
Author Elizabeth M Lamos, Marniker A Wijesinha, Seba Ramhmdani, Laurence S Magder, Kristi D Silver
Keywords diabetes mellitus, hypoglycemia, Infection, length of stay, renal transplantation
Abstract

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 (=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; =0.02) or >180 mg/dL (OR=1.9; =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; =0.01) or >180 mg/dL (OR=0.4; =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.

Year of Publication
2017
Journal
Diabetes, metabolic syndrome and obesity : targets and therapy
Volume
10
Number of Pages
13-17
Date Published
12/2017
ISSN Number
1178-7007
DOI
10.2147/DMSO.S118437
Alternate Journal
Diabetes Metab Syndr Obes
PMID
28115861
PMCID
PMC5221556
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