High Glucose Variability Increases 30-Day Readmission Rates in Patients with Type 2 Diabetes Hospitalized in Department of Surgery

Glucose variability is common among hospitalized
patients with type 2 diabetes mellitus (DM). I investigated to assess the
variability of glucose in patients with type 2 DM accounts for in-hospital
readmission rates in department of Surgery.

I retrospectively
analyzed 206 patients with type 2 DM, who was admitted to our hospital for
surgical interventions and re-admitted within 30 days after discharge.
I also enrolled 610 age, sex and diabetic duration matched patients with type 2
DM, as control. Outcomes
measure included average and standard deviation (SD) of blood glucose during admission, glycated hemoglobin (HbA1c), lipid profile, renal
function, length of stay (LOS).

Patients who had re-admission within 30 days after
discharge had higher SD of blood glucose levels than control (84.7 ±
53.5 mg/dL vs. 46.2 ±
42.8 mg/dL, p <0.001) but not
average of blood glucose levels. Comparing to control group, the study group
also had higher HbA1c (8.4 ±
1.3% vs. 7.7 ±
1.1%, p = 0.015) and LOS (8.5± 2.5 days vs 7.0± 1.5 days, p =
0.020). The independent predictors of 30-day readmission rates were
SD of blood glucose during admission and HbA1c (hazard
ratio: 1.680, 1.493; p value <
0.001, 0.008, respectively.)

Decreasing glucose variability
during admission for surgery is important for patients with type 2 DM to
decreasing re-admission rates and LOS. HBA1c may also identify
patients at higher risk of postoperative complications and possibility of
re-admission.