Role of glycemic control on hospital-related outcomes in patients with diabetes mellitus undergoing renal transplantation
Authors Lamos EM, Wijesinha MA, Ramhmdani S, Magder LS, Silver KD
Received 29 July 2016
Accepted for publication 20 October 2016
Published 5 January 2017 Volume 2017:10 Pages 13—17
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Ming-Hui Zou
Elizabeth M Lamos,1 Marniker A Wijesinha,2 Seba Ramhmdani,1 Laurence S Magder,2 Kristi D Silver1
1Division of Endocrinology, Diabetes and Nutrition, 2Department of Epidemiology, University of Maryland School of Medicine, Baltimore, MD, USA
Objective: To compare length of stay (LOS) and incidence of hypoglycemic events and infections in hospitalized patients with diabetes mellitus (DM) undergoing renal transplantation, among groups of patients defined by admission glucose and mean inpatient daily glucose.
Methods: A retrospective analysis of 190 charts of patients with DM who underwent renal transplantation over a 2-year period was conducted. Patients were grouped according to admission glucose and mean inpatient daily glucose (≤140 mg/dL, 141–180 mg/dL, and >180 mg/dL).
Results: Admission glucose was not associated with LOS. A mean inpatient daily glucose of ≤140 mg/dL was associated with a longer LOS compared to a mean inpatient daily glucose of >180 mg/dL (p=0.03). Patients with an admission glucose of ≤140 mg/dL had approximately half the rate of hypoglycemic events compared to those with admission glucose of 141−180 mg/dL (odds ratio [OR]=2.1; p=0.02) or >180 mg/dL (OR=1.9; p=0.04). However, patients whose mean daily glucose was ≤140 mg/dL had approximately twice the rate of hypoglycemic events than those whose mean daily glucose was 141−180 mg/dL (OR=0.4; p=0.01) or >180 mg/dL (OR=0.4; p=0.004). The incidence of infections was low and was not associated with admission or mean daily glucose levels.
Conclusion: Lower mean daily inpatient glucose levels (≤140 mg/dL) are associated with longer LOS and greater incidence of hypoglycemic episodes in diabetes patients undergoing renal transplantation. Our findings suggest that target blood glucose levels of 140−180 mg/dL may be appropriate in this specific population. Additional prospective research is needed to confirm these findings.
Keywords: diabetes mellitus, renal transplantation, length of stay, hypoglycemia, infection
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