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International Journal of Endocrinology
Volume 2015, Article ID 381415, 5 pages
http://dx.doi.org/10.1155/2015/381415
Research Article

Breaking Therapeutic Inertia in Type 2 Diabetes: Active Detection of In-Patient Cases Allows Improvement of Metabolic Control at Midterm

1Endocrinology and Nutrition Service, Germans Trias i Pujol Research Institute and Hospital, Department of Medicine, Autonomous University of Barcelona, Can Ruti Campus, Ctra. Canyet s/n, Badalona, 08916 Barcelona, Spain
2Hormone Laboratory, Germans Trias i Pujol Research Institute and Hospital, Department of Medicine, Autonomous University of Barcelona, Can Ruti Campus, Ctra. Canyet s/n, Badalona, 08916 Barcelona, Spain

Received 25 July 2014; Revised 5 October 2014; Accepted 5 October 2014

Academic Editor: Ilias Migdalis

Copyright © 2015 Anna M. Lucas Martín et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Type 2 diabetes (T2D) exists in 25–40% of hospitalized patients. Therapeutic inertia is the delay in the intensification of a treatment and it is frequent in T2D. The objectives of this study were to detect patients admitted to surgical wards with hyperglycaemia (HH; fasting glycaemia > 140 mg/dL) as well as those with T2D and suboptimal chronic glycaemic control (SCGC) and to assess the midterm impact of treatment modifications indicated at discharge. A total of 412 HH patients were detected in a period of 18 months; 86.6% (357) had a diagnosed T2D. Their preadmittance was 7.7 ± 1.5%; 47% (189) had ≥ 7.4% (SCGC) and were moved to the upper step in the therapeutic algorithm at discharge. Another 15 subjects (3.6% of the cohort) had T2D according to their current . Ninety-four of the 189 SCGC patients were evaluated 3–6 months later. Their before in-hospital-intervention was 8.6 ± 1.2% and 7.5 ± 1.2% at follow-up (). Active detection of hyperglycaemia in patients admitted in conventional surgical beds permits the identification of T2D patients with SCGC as well as previously unknown cases. A shift to the upper step in the therapeutic algorithm at discharge improves this control. Hospitalization is an opportunity to break therapeutic inertia.