Table 2.
Comparison of key glucometrics between June to August 2013 and June to August 2016
| June to August 2013 | June to August 2016 | Effect measuresa (95% CI) |
P-value | |
|---|---|---|---|---|
| Patient-days | 21,399 | 17,876 | ||
| Admissions | 3315 | 3130 | ||
| HYPOGLYCEMIA METRICS | ||||
| Patient-day level | ||||
| Hypoglycemia, any glucose, n (%) | ||||
| < 4 mmol/L | 997 (4.7) | 588 (3.3) | 0.71 (0.61 to 0.83) | < 0.001 |
| < 3 mmol/L | 196 (0.9) | 83 (0.5) | 0.51 (0.38 to 0.7) | < 0.001 |
| < 2.5 mmol/Lb | 55 (0.3) | 22 (0.1) | 0.52 (0.28 to 0.96) | 0.035 |
| Admission level | ||||
| Hypoglycemia, any glucose, n (%) | ||||
| < 4 mmol/L | 556 (16.8) | 384 (12.3) | 0.72 (0.62 to 0.83) | < 0.001 |
| < 3 mmol/L | 141 (4.3) | 71 (2.3) | 0.54 (0.4 to 0.73) | < 0.001 |
| < 2.5 mmol/Lb | 42 (1.3) | 17 (0.5) | 0.45 (0.26 to 0.78) | 0.005 |
| Recurrence of hypoglycemia, number of days with any glucose < 4 mmol/L, n (%) | ||||
| Exactly 1 dayc | 345 (10.4) | 252 (8.1) | 0.76 (0.64 to 0.9) | 0.002 |
| 2 or more daysc | 211 (6.4) | 132 (4.2) | 0.65 (0.52 to 0.83) | < 0.001 |
| HYPERGLYCEMIA AND OTHER METRICS | ||||
| Patient-day level | ||||
| Hyperglycemia, any glucose, n (%) | ||||
| > 14 mmol/L | 5929 (27.7) | 4678 (26.2) | 0.84 (0.71 to 0.99) | 0.041 |
| > 20 mmol/L | 1255 (5.9) | 843 (4.7) | 0.81 (0.66 to 0.99) | 0.039 |
| Mean glucose in desired range, n (%) | ||||
| Within 4–10 mmol/L | 13,206 (61.7) | 11,357 (63.5) | 1.11 (0.93 to 1.33) | 0.237 |
| Mean glucose, mean (SD) | 9.7 (3.3) | 9.6 (3.2) | 0.98 (0.94 to 1.02) | 0.342 |
| SD of glucose, mean (SD) | 2.4 (1.7) | 2.3 (1.6) | 0.95 (0.92 to 0.98) | 0.001 |
| Admission level | ||||
| Hyperglycemia, any glucose, n (%) | ||||
| > 14 mmol/L | 1838 (55.4) | 1616 (51.6) | 0.87 (0.79 to 0.97) | 0.01 |
| > 20 mmol/L | 608 (18.3) | 459 (14.7) | 0.79 (0.69 to 0.92) | 0.002 |
| Mean glucose in desired range, n (%) | ||||
| Within 4–10 mmol/L | 1986 (59.9) | 1957 (62.5) | 1.14 (1.02 to 1.27) | 0.022 |
| HGI, mean (SD) | 0.49 (0.99) | 0.42 (0.92) | 0.68 (0.53 to 0.88) | 0.004 |
| Mean glucose, mean (SD) | 9.8 (2.7) | 9.6 (2.6) | 0.98 (0.96 to 0.99) | < 0.001 |
| SD of glucose, mean (SD) | 2.9 (1.4) | 2.7 (1.3) | 0.95 (0.92 to 0.97) | < 0.001 |
| LOS (in days), mean (SD)d | 7.5 (7.9) | 7.2 (6.8) | 1.01 (0.96 to 1.05) | 0.793 |
aThe associations between glucometrics and the time periods were fully adjusted with respect to age, gender, ethnicity groups, emergency admission, type of ward, and illness severity status. For mean glucose, SD (standard deviation) of glucose, HGI (Hyperglycemia Index) with threshold being 14 mmol/L, and LOS (length of stay), Poisson regression model with Generalized Estimation Equations (GEE) was applied and mean ratios were reported with 95% CI within the brackets. For other metrics, logistic regression model with GEE was applied and odds ratios were reported with 95% CI within the brackets
bBlood glucose < 2.5 mmol/L is considered biochemically severe hypoglycemia
cFor recurrence of hypoglycemia, the comparison reference group is always admissions without any glucose < 4 mmol/L, i.e., zero days with any glucose < 4 mmol/L.
dThe associations between length of stay and the time periods were fully adjusted with respect to age, gender, ethnicity groups, emergency admission, type of ward, illness severity status, and glucometrics