(Press-News.org) BOSTON -- Diabetes patients with abnormal blood sugar levels had longer, more costly hospital stays than those with glucose levels in a healthy range, according to studies presented by Scripps Whittier Diabetes Institute researchers at the 75th Scientific Sessions of the American Diabetes Association (ADA), which ends June 9 in Boston.
The findings come as more patients are being admitted into U.S. hospitals with diabetes as an underlying condition. A recent UCLA public health report indicated that one of every three hospital patients admitted in California has a diagnosis of diabetes. At the same time, changing health care payment models are increasing pressure on health systems to reduce costs while improving patient outcomes.
'Data from the new studies suggest poorly controlled blood sugar readings could serve as a marker for better managing the care of patients with diabetes both during their hospital stays and after they have been discharged,' said Athena Philis-Tsimikas, M.D., an endocrinologist, corporate vice president of the Scripps Whittier Diabetes Institute and co-author of the papers presented at the ADA conference.
'Our research supports having more caregivers in the hospital and clinic settings who are focused on identifying these patients and working to make sure their diabetes is properly managed,' she said.
For the first study, researchers used data for 9,995 patients with diabetes who were admitted to all Scripps Health hospitals in San Diego county between 2012 and 2013 and underwent blood sugar monitoring during their stays.
After controlling for age and gender, patients with poor glucose control (one or more readings exceeding 400 mg/dL) had significantly longer hospital stays averaging 8.50 days than those with good glucose control (readings ranging between 70 and 199 mg/dL) who had stays averaging 5.74 days. Total hospitalization costs for patients with poor glucose control averaged $16,382, while costs for patients with good blood sugar control averaged $13,896.
The second study examined blood sugar data for 2,024 patients with diabetes who were admitted to Scripps Memorial Hospital Encinitas between 2009 and 2011.
After adjusting for patient demographics, admitted medical conditions and severity of illness, those who experienced high glucose readings (greater than 180 mg/dL) or low glucose readings (below 70 mg/dL) had significantly longer stays and incurred higher total costs when compared with patients whose glucose levels remained in normal ranges during their hospitalization.
A third study looked at diabetes patients receiving care at two Scripps Coastal Medical Center ambulatory clinics in San Diego county. At one clinic, 236 patients (the intervention group) received conventional support along with care from a multidisciplinary team that included a nurse care manager, a nurse focused on managing patient depression and a health coach. At the other clinic, another 238 patients served as a comparison group, receiving only conventional support during the same period.
Over 12 months, the percentage of all intervention group patients with good control of glycated hemoglobin (HbA1c), which is a risk indicator for developing diabetes-related conditions, increased significantly from 75.8 to 91.8. At the same time, the percentage of patients in the comparison group with good control of HbA1c rose only slightly from 77.3 to 79.2.
Among a subset of interventional group patients with moderate or high risk of developing diabetes-related complications, the percent with good control of HbA1c increased from 63.5 to 90.2.
Taken together, the research supports efforts by Tsimikas for more than 15 years to imbed multidisciplinary teams focused on diabetes care and management in clinics and hospitals.
'We don't have enough physicians who can care for every patient for the amount of time required,' she said. 'Surrounding doctors with a specialized care team lets them provide more effective care to patients with diabetes, operate more efficiently and deliver improved outcomes.'
The Scripps Whittier Diabetes Institute's Project Dulce is one example of how this approach can work. Through a collaboration with San Diego county and several other partners, multidisciplinary care teams that include registered dietitians, health coaches and trained peer educators provide clinical care and management for diabetes patients in federally qualified community health centers throughout San Diego county.
Multiple studies have found the Project Dulce program to be associated with improvements in health status and quality of life, a decreased incidence of diabetes-related complications and hospitalizations, and lower hospital and emergency department care costs.
INFORMATION:
Co-authors of the studies presented at the ADA conference included Addie L. Fortmann, Ph.D., research scientist; Laura Talavera, R.N., C.N.S., manager of inpatient diabetes services; Deborah Sims, project management analyst; Nakiya Davis, project manager; Chris Walker, M.P.H., senior director of diabetes services; Kelly Barger, R.D., C.D.E., diabetes education supervisor; Maire Robacker, R.N., C.N.S., C.D.E.; Cindy Garvey, R.N., C.D.E., diabetes educator; Christine Strohmeyer, M.D.; Louis Hogrefe, M.D.; Robin Morrisey, R.N., N.P., manager of outpatient diabetes services; and Clinton Desmond, data manager.
About scripps health
Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a nonprofit integrated health system based in San Diego, Calif. Scripps treats more than 600,000 patients annually through the dedication of 2,600 affiliated physicians and more than 14,000 employees among its five acute-care hospital campuses, hospice and home health care services, 28 outpatient centers and clinics, and hundreds of physician offices throughout the region.
Recognized as a leader in prevention, diagnosis and treatment, Scripps is also at the forefront of clinical research, genomic medicine and wireless health care. With three highly respected graduate medical education programs, Scripps is a longstanding member of the Association of American Medical Colleges. Scripps hospitals are consistently ranked by U.S. News & World Report among the nation's best and Scripps is regularly recognized by Fortune, Working Mother magazine and AARP as one of the best places in the nation to work. More information can be found at http://www.scripps.org.
BOSTON (June 8, 2015) -- One member of a widely prescribed class of drugs used to lower blood glucose levels in people with diabetes has a neutral effect on heart failure and other cardiovascular problems, according to the first clinical trial to examine cardiovascular safety in a GLP-1 receptor agonist, presented at the American Diabetes Association's 75th Scientific Sessions.
The Evaluation of Lixisenatide in Acute Coronary Syndrome (ELIXA) study also found a modest benefit for weight control, and no increase of risk for hypoglycemia or pancreatic injury in those who ...
A team of researchers from UC San Diego, Florida State University and Pacific Northwest National Laboratories has for the first time visualized the growth of 'nanoscale' chemical complexes in real time, demonstrating that processes in liquids at the scale of one-billionth of a meter can be documented as they happen.
The achievement, which will make possible many future advances in nanotechnology, is detailed in a paper published online today in the Journal of the American Chemical Society. Chemists and material scientists will be able to use this new development in their ...
ALMA's Long Baseline Campaign has produced a spectacularly detailed image of a distant galaxy being gravitationally lensed. The image shows a magnified view of the galaxy's star-forming regions, the likes of which have never been seen before at this level of detail in a galaxy so remote. The new observations are far more detailed than those made using the NASA/ESA Hubble Space Telescope, and reveal star-forming clumps in the galaxy equivalent to giant versions of the Orion Nebula.
ALMA's Long Baseline Campaign has produced some amazing observations, and gathered unprecedentedly ...
An international, multidisciplinary team including investigators from Brigham and Women's Hospital (BWH) has found that lixisenatide, a member of a class of glucose-lowering drugs frequently prescribed in Europe to patients with diabetes, did not increase risk of cardiovascular events including heart failure. These results - the first to be reported on the cardiovascular safety of a glucagon-like peptide 1 (GLP-1) receptor agonist - were presented today at the American Diabetes Association's 75th Scientific Sessions.
"There are a large number of patients around the world ...
ORANGE, Calif. -- In a study just published by researchers at Chapman University, findings showed that greater life satisfaction in adults older than 50 years of age is related to a reduced risk of mortality. The researchers also found that variability in life satisfaction across time increases risk of mortality, but only among less satisfied people. The study involved nearly 4,500 participants who were followed for up to nine years.
'Although life satisfaction is typically considered relatively consistent across time, it may change in response to life circumstances ...
Glenview, Ill. (June 8, 2015)-- A Canadian study published in the June issue of the journal CHEST found weight loss reduced asthma severity as measured by airway hyperresponsiveness (AHR) in obese adults. The incidence of asthma is 1.47 times higher in obese people than nonobese people, and a three-unit increase in body mass index is associated with a 35% increase in the risk of asthma. The study supports the active treatment of comorbid obesity in individuals with asthma.
The study, the first of its kind to rely on appropriate physiologic tests as diagnostic criteria ...
Baltimore, Md. (Embargoed until 12:30 p.m. EDT, June 8, 2015) - Imaging lung cancer requires both precision and innovation. With this aim, researchers have developed a technique for clinical positron emission tomography (PET) imaging that creates advanced whole-body parametric maps, which allow quantitative evaluation of tumors and metastases throughout the body, according to research announced at the 2015 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
Scientists have developed a novel agent for cancer imaging that seeks and attaches ...
Baltimore, Md. (Embargoed until 12:30 p.m. EDT, June 8, 2015) - A first-in-human study revealed at the 2015 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) shows how a powerful new drug finds and attaches itself to the ovarian and prostate cancer cells for both imaging and personalized cancer treatment.
The targeted aspect of the imaging agent, called I-124 PEG-AVP0458, is a small protein (avibody) linked to polyethylene glycol (PEG) chains. The drug compound is then labeled with the radionuclide iodine-124. Drugs like PEG-AVP0458 are ...
Baltimore, Md. (Embargoed until 12:30 p.m. EDT, June 8, 2015) - Non-Hodgkin lymphoma (NHL), a potentially devastating cancer of the blood and immune system, can range from relatively easy to treat to very aggressive. For more aggressive cases, post-treatment surveillance with molecular imaging could mean the early start of a new, life-saving treatment, say researchers presenting during the 2015 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
NHL is the fifth most prevalent cancer in America, according to lead author Mehdi Taghipour, MD, ...
Baltimore, Md. (embargoed until 12:30 p.m. EDT, June 8, 2015) - Research presented at the 2015 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) shows how a new molecular imaging agent finds prostate cancer that has spread to other tissues by locking in on an enzyme called prostate specific membrane antigen (PSMA), associated with prostate cancer.
"To date, conventional imaging is limited in detecting prostate cancer metastasis accurately and measurably," said Neeta Pandit-Taskar, MD, co-author of the study and a researcher at Memorial Sloan ...
