Diabetes is a common chronic condition, affecting an estimated 1 in 20 Canadians. It is estimated that the health care budget contributes 13 billion dollars per year to the care of 2 million Canadians living with Diabetes.
Alberta data suggests that 1 in 5 adult patients admitted to hospital(s) in Alberta has diabetes; most patients are not admitted with a diagnosis of diabetes, yet diabetes is the fourth most common co-morbidity in patient charts.
In Alberta, patients with diabetes stay in hospital 40% longer than their counterparts without diabetes (3 days versus 5 days during the 2014/15 fiscal year).
If clinicians fail to recognize and treat hyperglycemia appropriately, patients with diabetes are at risk for:
Hyperglycemia in hospital has been associated with a poorer prognosis in medical and surgical patients, regardless of age, gender or type of diabetes. Literature has demonstrated poorer outcomes in patients with a wide array of medical and surgical conditions, ranging from:
Improving glycemic control in hospital has been associated with shorter length of stay in hospital and decreased rates of readmission, which in one study resulted in substantial cost-savings of $1500 per patient. Moreover, in a second study, implementing programs focused on treating hyperglycemia led to as much as a 450% return on investment.
Data from our early adopter sites in Alberta has demonstrated that using a knowledge translation approach to implement BBIT protocols in hospital has resulted in improved rates of hyperglycemia without increasing the rate of hypoglycemia. Length of stay was reduced by 10-14%.
Diabetes Canada recognizes that patients with diabetes have complex needs while in hospital and that the acuity of their illness, nutritional intake and activity are difficult to predict and treat appropriately. Diabetes Canada has recommended clinical practice guidelines for diabetes management in hospital. These recommendations include: