Use of a XXXX management service improves glycemic control following vascular surgery: an interrupted time-series study.

@entity1 @entity1095 @entity6 @entity3657 @entity63 @entity4456 @entity413
BACKGROUND: The optimal method for obtaining good blood @entity413 control in noncritically ill @entity1 undergoing peripheral vascular surgery remains a topic of debate for surgeons, endocrinologists, and others involved in the care of @entity1 with @entity3657 and @entity6 . A prospective trial was performed to evaluate the impact of routine use of a @entity413 management service (GMS) on glycemic control within 24 hours of lower-extremity revascularization (LER). METHODS: In an interrupted time-series design ( @entity4456 , 2011-April 30, 2012), surgeon-directed diabetic care (Baseline phase) to routine GMS involvement (Intervention phase) was compared following LER. GMS assumed responsibility for @entity413 management through discharge. The main outcome measure was glycemic control, assessed by (1) mean hospitalization @entity413 and (2) the percentage of recorded @entity413 values within target range. Statistical process control charts were used to assess the impact of the intervention. RESULTS: Clinically important differences in @entity1 demographics were noted between groups; the 19 @entity1 in the Intervention arm had worse @entity1095 than the 19 @entity1 in the Baseline arm (74% critical limb @entity63 versus 58%; p = .63). Routine use of GMS significantly reduced mean hospitalization @entity413 (191 mg/dL Baseline versus 150 mg/dL Intervention, p < .001). Further, the proportion of @entity413 values in target range increased (48% Baseline versus 78% Intervention, p = .05). Following removal of GMS involvement, measures of glycemic control did not significantly decrease for the 19 postintervention @entity1 . CONCLUSIONS: Routine involvement of GMS improved glycemic control in @entity1 undergoing LER. Future work is needed to examine the impact of improved glycemic control on clinical outcomes following LER.
