Table 1.
Patient characteristics (number of patients overall: N=158; patients in the enhanced standard care [ESC] arm: n=76; patients in the discharge order set [DOS] arm: n=82).
|
|
Overall | ESC | DOS | ||||
| Age (years), mean (SD) | 51.7 (10.2) | 51.4 (10.5) | 52 (10.1) | ||||
| Male, n (%) | 68 (43) | 33 (43.3) | 35 (42.7) | ||||
| White,a,b n (%) | 74 (46.8) | 34 (44.7) | 40 (48.8) | ||||
| Hispanic, n (%) | 3 (1.9) | 1 (1.3) | 2 (2.4) | ||||
| Diabetes duration (years), median (IQR) | 11 (7-20) | 14 (7-20) | 10 (6-15) | ||||
| BMI (kg/m2), mean (SD) | 38.2 (9.5) | 38.1 (8.7) | 38.4 (10.1) | ||||
| Past medical history, n (%) | |||||||
|
|
Hypertension | 134 (84.8) | 64 (84.2) | 70 (85.4) | |||
|
|
Hyperlipidemia | 98 (62) | 45 (59.2) | 53 (64.6) | |||
|
|
Coronary artery disease | 44 (27.9) | 18 (23.7) | 26 (31.7) | |||
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Heart failure | 37 (23.4) | 17 (22.4) | 20 (24.4) | |||
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Cerebrovascular disease | 21 (13.3) | 12 (15.8) | 9 (11) | |||
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Peripheral vascular disease | 14 (8.9) | 5 (6.6) | 9 (11) | |||
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Retinopathy | 28 (17.7) | 16 (21.1) | 12 (14.6) | |||
|
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Nephropathy | 39 (24.7) | 19 (25) | 20 (24.4) | |||
|
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Neuropathy | 81 (51.3) | 45 (59.2) | 36 (43.9) | |||
| Estimated glomerular filtration rate (mL/min/1.73 m2), mean (SD) | |||||||
|
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>60 | 109 (69) | 51 (67.1) | 58 (70.7) | |||
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30-60 | 39 (24.7) | 21 (27.6) | 18 (22) | |||
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<30 | 107 (6.3) | 4 (5.3) | 6 (7.43) | |||
| Charlson Comorbidity Index (total score), median (IQR) | 3 (2-5) | 3 (2-4.75) | 3 (2-5) | ||||
| Education, n (%) | |||||||
|
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Less than high school | 15 (9.5) | 10 (13.2) | 5 (6.1) | |||
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High school or equivalent | 118 (74.7) | 55 (72.4) | 63 (76.8) | |||
|
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Bachelor’s degree | 25 (15.8) | 11 (14.5) | 14 (17.1) | |||
| Marital status, n (%) | |||||||
|
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Single, never married | 46 (29.1) | 22 (30) | 24 (29.3) | |||
|
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Married or domestic partnership | 66 (41.8) | 25 (32.9) | 41 (50) | |||
|
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Divorced, separated, or widowed | 46 (29.1) | 29 (38.2) | 17 (20.7) | |||
| Work status, n (%) | |||||||
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Employed | 63 (39.9) | 33 (43.4) | 30 (36.6) | |||
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Unemployed | 23 (14.6) | 11 (14.5) | 12 (14.6) | |||
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Retired | 21 (13.3) | 10 (13.2) | 11 (13.4) | |||
|
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Unable to work | 51 (32.3) | 22 (29) | 29 (35.4) | |||
| Home ownership, n (%) | |||||||
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Own | 58 (36.7) | 28 (36.8) | 30 (36.6) | |||
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Other | 100 (63.3) | 48 (63.1) | 52 (63.4) | |||
| Insurance, n (%) | |||||||
|
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None | 11 (7) | 7 (9.2) | 4 (4.9) | |||
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Private | 52 (32.9) | 22 (29.0) | 30 (36.7) | |||
|
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Medicare | 35 (22.1) | 18 (23.7) | 17 (20.7) | |||
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Medicaid | 60 (38) | 29 (38.2) | 31 (37.8) | |||
| Primary reason for admission, n (%) | |||||||
|
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Cardiovascular | 40 (25.3) | 21 (27.6) | 19 (23.2) | |||
|
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Gastrointestinal | 16 (10.1) | 8 (10.5) | 8 (9.8) | |||
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Infectious disease | 28 (17.7) | 12 (15.8) | 16 (19.5) | |||
|
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Other | 74 (46.8) | 35 (46.1) | 39 (47.6) | |||
| Admission service, n (%) | |||||||
|
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General medicine | 33 (20.9) | 16 (21.1) | 17 (20.7) | |||
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Family medicine | 5 (3.2) | 3 (4) | 2 (2.4) | |||
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Cardiology | 23 (14.5) | 15 (19.7) | 8 (9.8) | |||
|
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Surgery | 6 (3.8) | 2 (2.6) | 4 (4.9) | |||
| Admission severe hyperglycemia,c n (%) | 19 (12.1) | 8 (10.5) | 11 (13.6) | ||||
| Hospital length of stay (days), median (IQR) | 5 (3-8) | 5 (3-8) | 5 (3-8) | ||||
| Diabetes consult, n (%) | 62 (39.2) | 26 (34.2) | 36 (43.9) | ||||
| Education consult, n (%) | 29 (18.4) | 11 (14.5) | 18 (22) | ||||
| Admission diabetes medications, n (%) | |||||||
|
|
Any insulin | 127 (80.9) | 63 (82.9) | 64 (79) | |||
|
|
Basal insulin | 126 (80) | 64 (84.2) | 62 (76.5) | |||
|
|
Premix insulin | 1 (0.64) | 1 (1.3) | 0 (0) | |||
|
|
Bolus insulin | 82 (52.2) | 40 (52.6) | 42 (51.9) | |||
|
|
Metformin | 53 (33.5) | 25 (32.9) | 28 (34.2) | |||
|
|
Sulfonylurea or glinide | 12 (7.6) | 7 (9.2) | 5 (6.1) | |||
|
|
SGLT2d inhibitor | 11 (7) | 4 (5.3) | 7 (8.5) | |||
|
|
DPP-4e inhibitor | 6 (3.8) | 4 (5.3) | 2 (2.4) | |||
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|
GLP-1f receptor agonist | 26 (16.5) | 14 (18.4) | 12 (14.6) | |||
|
|
Other | 1 (0.63) | 0 (0) | 1 (1.2) | |||
| Other admission medications, n (%) | |||||||
|
|
Statin | 120 (76) | 57 (75) | 63 (76.8) | |||
|
|
ACEIg or ARBh | 80 (50.6) | 41 (54) | 39 (47.6) | |||
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β-blocker | 73 (46.2) | 37 (46.7) | 36 (43.9) | |||
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Glucocorticoids | 5 (3.2) | 1 (1.3) | 4 (4.9) | |||
|
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Aspirin | 84 (53.2) | 42 (55.3) | 42 (51.2) | |||
| Discharge diabetes medications | |||||||
|
|
Total insulin dose (unit), median (IQR) | 68 (42-115) | 74 (43-116) | 68 (37.8-112.5) | |||
|
|
Total insulin dose (unit/kg/day), median (IQR) | 0.61 (0.38-1.03) | 0.59 (0.39-1.03) | 0.69 (0.39-1.03) | |||
|
|
Basal insulin | 41 (30, 75) | 50 (30, 74) | 41 (30, 78.7) | |||
|
|
Bolus insulin | 123 (79) | 63 (79) | 60 (80) | |||
|
|
Metformin, n (%) | 56 (36.1) | 26 (34.7) | 30 (37.5) | |||
|
|
Sulfonylurea or glinide, n (%) | 6 (3.8) | 3 (4) | 3 (3.8) | |||
|
|
SGLT2-inhibitor, n (%) | 5 (3.2) | 5 (6.7) | 0 (0) | |||
|
|
DPP-4 inhibitor, n (%) | 10 (6.5) | 6 (8) | 4 (5) | |||
|
|
GLP-1 receptor agonist, n (%) | 24 (15.5) | 14 (18.7) | 10 (12.5) | |||
| Diabetes empowerment scale [26], median (IQR) | 4.4 (4-4.8) | 4.4 (4-4.8) | 4.3 (3.9-4.8) | ||||
| Functional health literacy [27], median (IQR) | 4 (2-6) | 4 (2-6) | 5 (3-6) | ||||
| Multidimensional scale of perceived social support [28], median (IQR) | 6 (4.9-6.8) | 6.1 (5-6.8) | 5.9 (4.7-6.8) | ||||
aRace was categorized as White (46.5%), Black (52.3%), Asian (0.65%), or other (0.65%).
bChi-square analysis could not be performed owing to insufficient cell count.
cAdmission for diabetic ketoacidosis, nonketotic hyperglycemic hyperosmolar state, or diabetes as the primary indication for admission.
dSGLT2: sodium-glucose cotransporter-2.
eDPP-4: dipeptidyl peptidase-4.
fGLP-1: glucagon-like peptide-1.
gACEI: angiotensin-converting enzyme inhibitor-1.
hARB: angiotensin receptor blocker.