The Patterns of Inpatient Diabetes Management Between Endocrinologists and Nonendocrinologists in a General Internal Medicine Ward

Po-Hsun Chen ； Shih-Yi Lin ； Wayne Huey-Herng Sheu ； I-Te Lee

《Formosan Journal of Endocrinology and Metabolism》 4卷2期 (2013/12) Pp. 39-44

https://doi.org/10.6856/FJEM.201312_4(2).0003

摘要

Background. Studies have reported that physician characteristics might determine the quality of inpatient care. We assessed the care patterns of type 2 diabetic inpatients by attending physicians of different specialties in a general internal medicine (GM) ward. Methods. All type 2 diabetic patients were divided into either a cared-for-by-nonendocrinologists (non-EM/GM) group or a cared-for-by-endocrinologists (EM/GM) group. We also studied the care pattern of diabetes patients by another endocrinologist in an endocrinology and metabolism ward (EM/ EM group). All data were retrospectively recorded from medical charts. Results. A total of 206 study participants were enrolled. The reductions in fasting blood glucose during hospitalization did not significantly differ (22 ± 11 mg/dL in the non-EM/GM group, 21 ± 9 mg/ dL in the EM/GM group, and 20 ± 9 mg/dL in the EM/EM group, P = 0.91). The GM ward favored oral-insulin secretagogues (odds ratio [OR] = 2.97, P = 0.010) rather than insulin therapy (OR = 0.50, P = 0.037). A high proportion of patients with renal impairment were administered metformin by the group of physicians who were not endocrinologists (P = 0.010). Conclusion. Glycemic control and hypoglycemic rates did not significantly differ among patients cared for by various attending physicians, but the medication chosen for diabetic patients was distinctive between physicians with and without an endocrinology specialty.

關鍵字

disease management ； type 2 diabetes ； inpatients