Effect of an educational Inpatient Diabetes Management Program on medical resident knowledge and measures of glycemic control: a randomized controlled trial.

Abstract

OBJECTIVE:

To investigate the effectiveness of an Inpatient Diabetes Management Program (IDMP) on physician knowledge and inpatient glycemic control.

METHODS:

Residents assigned to General Internal Medicine inpatient services were randomized to receive the IDMP (IDMP group) or usual education only (non-IDMP group). Both groups received an overview of inpatient diabetes management in conjunction with reminders of existing order sets on the hospital Web site. The IDMP group received print copies of the program and access to an electronic version for a personal digital assistant (PDA). A Diabetes Knowledge Test (DKT) was administered at baseline and at the end of the 1-month rotation. The frequency of hyperglycemia among patients under surveillance by each group was compared by using capillary blood glucose values and a dispersion index of glycemic variability. IDMP users completed a questionnaire related to the program.

RESULTS:

Twenty-two residents participated (11 in the IDMP group and 11 in the non-IDMP group). Overall Diabetes Knowledge Test scores improved in both groups (IDMP: 69% ± 1.7% versus 83% ± 2.1%, P = .003; non-IDMP: 76% ± 1.2% versus 84% ± 1.4%, P = .02). The percentage of correct responses for management of corticosteroid-associated hyperglycemia (P = .004) and preoperative glycemic management (P = .006) improved in only the IDMP group. The frequency of hyperglycemia (blood glucose level >180 mg/dL) and the dispersion index (5.3 ± 7.6 versus 3.7 ± 5.6; P = .2) were similar between the 2 groups.

CONCLUSION:

An IDMP was effective at improving physician knowledge for managing hyperglycemia in hospitalized patients treated with corticosteroids or in preparation for surgical procedures. Educational programs directed at improving overall health care provider knowledge for inpatient glycemic management may be beneficial; however, improvements in knowledge do not necessarily result in improved glycemic outcomes.

• Authors: Marisa E Desimone, Gary E Blank, Mohamed Virji, Amy Donihi, Monica DiNardo, Deborah M Simak, Raquel Buranosky, Mary T Korytkowski
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) 2012 Mar-Apr Vol. 18 Issue 2 Pg. 238-49 ISSN: 1934-2403 [Electronic] United States
• PMID: 22440993 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Adrenal Cortex Hormones
• Blood Glucose

Topics

• Academic Medical Centers
• Adrenal Cortex Hormones (adverse effects, therapeutic use)
• Blood Glucose (analysis)
• Clinical Competence
• Computers, Handheld
• Decision Support Techniques
• Diabetes Complications (drug therapy, surgery)
• Diabetes Mellitus (blood, therapy)
• Humans
• Hyperglycemia (chemically induced, prevention & control)
• Inpatients (education)
• Internet
• Internship and Residency
• Patient Education as Topic
• Pennsylvania
• Preoperative Care (adverse effects)
• Students, Medical
• Surveys and Questionnaires