Boaz Mona, Landau Zohar, Matas Zipora, Wainstein Julio
Epidemiology and Research Unit, E. Wolfson Medical Center, Holon, Israel.
J Diabetes Sci Technol. 2009 Sep 1;3(5):1168-74. doi: 10.1177/193229680900300523.
The ability to measure patient blood glucose levels at bedside in hospitalized patients and to transmit those values to a central database enables and facilitates glucose control and follow-up and is an integral component in the care of the hospitalized diabetic patient.
The goal of this study was to evaluate the performance of an institutional glucometer employed in the framework of the Program for the Treatment of the Hospitalized Diabetic Patient (PTHDP) at E. Wolfson Medical Center, Holon, Israel.
As part of the program to facilitate glucose control in hospitalized diabetic patients, an institutional glucometer was employed that permits uploading of data from stands located in each inpatient department and downloading of that data to a central hospital-wide database. Blood glucose values from hospitalized diabetic patients were collected from August 2007 to October 2008. The inpatient glucose control program was introduced gradually beginning January 2008.
During the follow-up period, more than 150,000 blood glucose measures were taken. Mean glucose was 195.7 +/- 99.12 mg/dl during the follow-up period. Blood glucose values declined from 206 +/- 105 prior to PTHDP (August 2007-December 2007) to 186 +/- 92 after its inception (January 2008-October 2008). The decline was associated significantly with time (r = 0.11, p < 0.0001). The prevalence of blood glucose values lower than 60 mg/dl was 1.48% [95% confidence interval (CI) 0.36%] prior to vs 1.55% (95% CI 0.37%) following implementation of the PTHDP. Concomitantly, a significant increase in the proportion of blood glucose values between 80 and 200 mg/dl was observed, from 55.5% prior to program initiation vs 61.6% after program initiation (p < 0.0001).
The present study was designed to observe changes in institution-wide glucose values following implementation of the PTHDP. Information was extracted from the glucometer system itself. Because the aforementioned study was not a clinical trial, we cannot rule out that factors other than introduction of the program could explain some of the variability observed. With these limitations in mind, it nevertheless appears that the PTHDP, of which the institutional glucometer is an integral, essential component, was associated with improved blood glucose values in the hospitalized diabetic patient.
在住院患者床边测量血糖水平并将这些值传输到中央数据库的能力，有助于实现并促进血糖控制及后续跟进，是住院糖尿病患者护理的重要组成部分。
本研究旨在评估以色列霍隆市E. 沃尔夫森医疗中心在住院糖尿病患者治疗项目（PTHDP）框架下使用的机构血糖仪的性能。
作为促进住院糖尿病患者血糖控制项目的一部分，采用了一种机构血糖仪，它允许从每个住院科室的血糖仪上传数据，并将数据下载到全院范围的中央数据库。收集了2007年8月至2008年10月期间住院糖尿病患者的血糖值。住院血糖控制项目于2008年1月开始逐步推行。
在随访期间，共进行了超过150,000次血糖测量。随访期间平均血糖为195.7±99.12mg/dl。血糖值从PTHDP实施前（2007年8月至2007年12月）的206±105降至实施后（2008年1月至2008年10月）的186±92。这种下降与时间显著相关（r = 0.11，p < 0.0001）。血糖值低于60mg/dl的患病率在PTHDP实施前为1.48% [95%置信区间（CI）0.36%]，实施后为1.55%（95%CI 0.37%）。同时，观察到血糖值在80至200mg/dl之间的比例显著增加，从项目启动前的55.5%增至项目启动后的61.6%（p < 0.0001）。
本研究旨在观察PTHDP实施后全院血糖值的变化。信息从血糖仪系统本身提取。由于上述研究并非临床试验，我们无法排除除项目引入之外的其他因素可能解释部分观察到的变异性。考虑到这些局限性，尽管如此，似乎以机构血糖仪为不可或缺的重要组成部分的PTHDP，与住院糖尿病患者血糖值的改善相关。
