BACKGROUND: There is increasing awareness of the morbidity and mortality associated with hyperglycaemia in hospital inpatients. The analysis of point of care blood glucose measurements (POC-BG) or ‘inpatient glucometrics’ has been suggested as an important measure of in-hospital glycaemic control.
OBJECTIVE: To examine the feasibility of utilising glucometrics in patients at the Royal Melbourne Hospital as part of a hospital wide diabetes care improvement project.
METHODS: 14192 point of care blood glucose (POC-BG) measurements were extracted from 57 blood glucose meters on one day.
RESULTS: All inpatient units were represented: 72% blood glucose level (BGL) measurements were from general wards, 18% from ICU, 5% from psychiatry and 3% from operating theatres. There were also 328 measurements (2%) from outpatients. 43% of BGL measurements were taken between 8am and 5pm, 20% between 5pm and 10pm, 28% between 10pm and 6am and 9% in the early morning between 6am-8am. The mean BGL across all glucose measurements was 9.4 mmol/L with mean values ranging from 8.07 mmol/L (BGLs from outpatients) to 10.45 mmol/L (BGLs from oncology wards). 57.5% of all BGL measurements were within the recommended glycaemic target of 4-10 mmol/L. 6.6% of all measurements were in the hypoglycaemic (< 4 mmol/L) range, 24.2% in the mildly hyperglycaemic range (>10-15 mmol/L), 10% in the moderately hyperglycaemic range (>15-20) and 1.8% in the severely hyperglycaemic (>20 mmol/L) range. There was no difference observed in glycaemic control between weekdays and weekends.
CONCLUSION: Hyperglycaemia is common in hospital inpatients. Glycaemic control varies across wards and between inpatient and outpatient settings. Glucometric analysis is a method of capturing current in-hospital glycaemic control that may be used to assess the effectiveness of future intervention strategies.