Skip to main content
Erschienen in: Current Diabetes Reports 10/2019

01.10.2019 | Hospital Management of Diabetes (A Wallia and JJ Seley, Section Editors)

Inpatient Diabetes Education in the Real World: an Overview of Guidelines and Delivery Models

verfasst von: Carine M. Nassar, Alex Montero, Michelle F. Magee

Erschienen in: Current Diabetes Reports | Ausgabe 10/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Diabetes self-management education and support improves diabetes-related outcomes, yet less than 50% of persons with diabetes in the USA receive this service. Hospital admissions present a critical opportunity for providing diabetes education. This article presents an overview of the current state of inpatient diabetes education. It incorporates a summary of existing guidance relative to content followed by an overarching discussion of existing inpatient diabetes education models and their reported outcomes, when available.

Recent Findings

As diabetes rates continue to soar and adults with diabetes continue to have high hospitalization and readmission rates, hospitals face challenges in assessing and meeting diabetes patients’ educational needs. The consensus recommendation for inpatient diabetes teaching is to provide survival skills education to enable safe self-management following discharge until more comprehensive outpatient education can be provided. Established and emerging models for delivery of diabetes survival skills education in the hospital may be broadly grouped as diabetes-specialty care models, diabetes non-specialty care models, and technology-supported diabetes education. These models are often shaped by the availability of diabetes specialists, including endocrinologists and diabetes educators—or lack thereof, and staffing resources for provision of services. Recent studies suggest that all three approaches can be deployed successfully if well planned.

Summary

This article presents an overview of the current state of inpatient diabetes education. It incorporates a summary of existing guidance relative to content followed by an overarching discussion of existing inpatient diabetes education models and their reported outcomes, when available. The authors seek to make the reader aware of the heterogeneous approaches that are being implemented nationwide for inpatient diabetes education delivery. Meeting inpatient diabetes educational needs will require a sustained effort, diverse strategies based on resources available, and additional research to explore the impact of these strategies on outcomes.
Literatur
1.
Zurück zum Zitat •• Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient Educ Couns. 2016;99(6):926–43. Findings from this review provide additional support for the effectiveness of DSME and its positive effect on glycemic control.CrossRef •• Chrvala CA, Sherr D, Lipman RD. Diabetes self-management education for adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic control. Patient Educ Couns. 2016;99(6):926–43. Findings from this review provide additional support for the effectiveness of DSME and its positive effect on glycemic control.CrossRef
2.
Zurück zum Zitat Magee MF, Khan NH, Desale S, Nassar CMK. Diabetes to go: knowledge and competency-based hospital survival skills education program improves post-discharge medication adherence. Diabetes Educ. 2014;40(3):344–50.CrossRef Magee MF, Khan NH, Desale S, Nassar CMK. Diabetes to go: knowledge and competency-based hospital survival skills education program improves post-discharge medication adherence. Diabetes Educ. 2014;40(3):344–50.CrossRef
3.
Zurück zum Zitat Healy SJ, Black D, Harris C, Lorenz A, Dungan KM. Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control. Diabetes Care. 2013;36:2960–7.CrossRef Healy SJ, Black D, Harris C, Lorenz A, Dungan KM. Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control. Diabetes Care. 2013;36:2960–7.CrossRef
4.
Zurück zum Zitat Li R, Shrestha SS, Lipman R, Burrows NR, Kolb LE, Rutledge S. Centers for disease control and prevention. Diabetes self-management education and training among privately insured persons with newly diagnosed diabetes—United States, 2011–2012. MMWR Morb Mortal Wkly Rep. 2014;63:1045–9.PubMedPubMedCentral Li R, Shrestha SS, Lipman R, Burrows NR, Kolb LE, Rutledge S. Centers for disease control and prevention. Diabetes self-management education and training among privately insured persons with newly diagnosed diabetes—United States, 2011–2012. MMWR Morb Mortal Wkly Rep. 2014;63:1045–9.PubMedPubMedCentral
7.
Zurück zum Zitat American Diabetes Association. Economic costs of diabetes in the US in 2012. Diabetes Care. 2013;36:1033–46.CrossRef American Diabetes Association. Economic costs of diabetes in the US in 2012. Diabetes Care. 2013;36:1033–46.CrossRef
8.
Zurück zum Zitat Rubin DJ, Donnell-Jackson K, Jhingan R, Golden SH, Paranjape A. Early readmission among patients with diabetes: a qualitative assessment of contributing factors. J Diabetes Complicat. 2014;28(6):86973.CrossRef Rubin DJ, Donnell-Jackson K, Jhingan R, Golden SH, Paranjape A. Early readmission among patients with diabetes: a qualitative assessment of contributing factors. J Diabetes Complicat. 2014;28(6):86973.CrossRef
9.
Zurück zum Zitat Dungan K, Lyons S, Manu K, Kulkarni M, Ebrahim K, Grantier C, et al. An individualized inpatient diabetes education and hospital transition program for poorly controlled hospitalized patients with diabetes. Endocr Pract. 2014;20(12):1265–73.PubMed Dungan K, Lyons S, Manu K, Kulkarni M, Ebrahim K, Grantier C, et al. An individualized inpatient diabetes education and hospital transition program for poorly controlled hospitalized patients with diabetes. Endocr Pract. 2014;20(12):1265–73.PubMed
10.
Zurück zum Zitat • Kuniss N, Muller UA. Substantial improvement in HbA1c following a treatment and teaching programme for people with type 2 diabetes on conventional insulin therapy in an in- and outpatient setting. Acta Diabetol. 2017. https://doi.org/10.1007/s00592-017-1070-2. Findings from this study suggest that a patient education intervention targeting optimization of insulin therapy in persons with type 2 diabetes was equally effective whether provided in the inpatient or outpatient setting.CrossRef • Kuniss N, Muller UA. Substantial improvement in HbA1c following a treatment and teaching programme for people with type 2 diabetes on conventional insulin therapy in an in- and outpatient setting. Acta Diabetol. 2017. https://​doi.​org/​10.​1007/​s00592-017-1070-2. Findings from this study suggest that a patient education intervention targeting optimization of insulin therapy in persons with type 2 diabetes was equally effective whether provided in the inpatient or outpatient setting.CrossRef
11.
Zurück zum Zitat American Diabetes Association. Diabetes care in the hospital: standards of medical care in diabetes-2019. Diabetes Care. 2019;42(Suppl. 1:S173–81.CrossRef American Diabetes Association. Diabetes care in the hospital: standards of medical care in diabetes-2019. Diabetes Care. 2019;42(Suppl. 1:S173–81.CrossRef
12.
Zurück zum Zitat Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer R, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553–91.CrossRef Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer R, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27(2):553–91.CrossRef
13.
Zurück zum Zitat Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American association of clinical endocrinologists and American Diabetes Association Consensus Statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119–31.CrossRef Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, et al. American association of clinical endocrinologists and American Diabetes Association Consensus Statement on inpatient glycemic control. Diabetes Care. 2009;32(6):1119–31.CrossRef
14.
Zurück zum Zitat Rubin DJ, Meneghini LF, Seley JJ, Cagliero E, Gaudiani M, Gilden GL. Transition of care: discharge from the hospital. In: Draznin B, editor. Managing diabetes and hyperglycemia in the hospital setting a clinician’s guide. American Diabetes Association, 2016; pp. 381–388. Rubin DJ, Meneghini LF, Seley JJ, Cagliero E, Gaudiani M, Gilden GL. Transition of care: discharge from the hospital. In: Draznin B, editor. Managing diabetes and hyperglycemia in the hospital setting a clinician’s guide. American Diabetes Association, 2016; pp. 381–388.
15.
Zurück zum Zitat Donihi AC. Practical recommendations for transitioning patients with type 2 diabetes from hospital to home. Curr Diab Rep. 2017;17(7):52.CrossRef Donihi AC. Practical recommendations for transitioning patients with type 2 diabetes from hospital to home. Curr Diab Rep. 2017;17(7):52.CrossRef
18.
Zurück zum Zitat Rinker J, Dickinson JK, Litchman ML, Williams AS, Kolb LE, Cox C, et al. The 2017 diabetes educator and the diabetes self-management education national practice survey. Diabetes Educ. 2018;44(3):260–8.CrossRef Rinker J, Dickinson JK, Litchman ML, Williams AS, Kolb LE, Cox C, et al. The 2017 diabetes educator and the diabetes self-management education national practice survey. Diabetes Educ. 2018;44(3):260–8.CrossRef
19.
Zurück zum Zitat Hellman R. An individualized inpatient diabetes education and hospital transition program for poorly controlled hospitalized patients with diabetes. Endocr Pract. 2014;20(10):10971099.CrossRef Hellman R. An individualized inpatient diabetes education and hospital transition program for poorly controlled hospitalized patients with diabetes. Endocr Pract. 2014;20(10):10971099.CrossRef
20.
Zurück zum Zitat •• Bansal V, Mottlib A, Pawar TK, Abbasakoor N, Chuang E, Chaudry A, et al. Inpatient diabetes management by specialized diabetes team versus primary service team in non-critical units: impact on 30-day readmission rate and hospital cost. BMJ Open Diabetes Res Care. 2018. https://doi.org/10.1136/bmjdrc-2017-000460. Findings from this study suggest that a specialized diabetes team providing inpatient diabetes care can reduce 30-day readmissions to non-critical care units by 30% as compared to standard diabetes care provided by a primary care team; as well as decrease hospital costs.CrossRef •• Bansal V, Mottlib A, Pawar TK, Abbasakoor N, Chuang E, Chaudry A, et al. Inpatient diabetes management by specialized diabetes team versus primary service team in non-critical units: impact on 30-day readmission rate and hospital cost. BMJ Open Diabetes Res Care. 2018. https://​doi.​org/​10.​1136/​bmjdrc-2017-000460. Findings from this study suggest that a specialized diabetes team providing inpatient diabetes care can reduce 30-day readmissions to non-critical care units by 30% as compared to standard diabetes care provided by a primary care team; as well as decrease hospital costs.CrossRef
21.
Zurück zum Zitat Wexler DJ, Beauharnais CC, Regan S, Nathan DM, Cagliero E, Larkin ME. Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge. Diabetes Res Clin Pract. 2012;98(2):249–56.CrossRef Wexler DJ, Beauharnais CC, Regan S, Nathan DM, Cagliero E, Larkin ME. Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge. Diabetes Res Clin Pract. 2012;98(2):249–56.CrossRef
22.
Zurück zum Zitat Ulisse G. Implementation of an inpatient diabetes management team in the university hospital setting. Diabetes Spectrum. 2010;23(2):131–3.CrossRef Ulisse G. Implementation of an inpatient diabetes management team in the university hospital setting. Diabetes Spectrum. 2010;23(2):131–3.CrossRef
23.
Zurück zum Zitat Munoz M, Pronovost P, Dintzis J, Kemmerer T, Wang N, Chang Y, et al. Implementing and evaluating a multicomponent inpatient diabetes management program: putting research into practice. Jt Comm J Qual Patient Saf. 2012;38(5):195–206.CrossRef Munoz M, Pronovost P, Dintzis J, Kemmerer T, Wang N, Chang Y, et al. Implementing and evaluating a multicomponent inpatient diabetes management program: putting research into practice. Jt Comm J Qual Patient Saf. 2012;38(5):195–206.CrossRef
24.
Zurück zum Zitat DeSantis AJ, Schmeltz LR, Schmidt K, O'Shea-Mahler E, Rhee C, Wells A, et al. Inpatient management of hyperglycemia: the northwestern experience. Endocr Pract. 2006;12:491–505.CrossRef DeSantis AJ, Schmeltz LR, Schmidt K, O'Shea-Mahler E, Rhee C, Wells A, et al. Inpatient management of hyperglycemia: the northwestern experience. Endocr Pract. 2006;12:491–505.CrossRef
25.
Zurück zum Zitat Hardee SG, Osborne KC, Njuguna N, Allis D, Brewington D, Patil SP, et al. Interdisciplinary diabetes care: a new model for inpatient diabetes education. Diabetes Spectrum. 2015;28(4):276–82.CrossRef Hardee SG, Osborne KC, Njuguna N, Allis D, Brewington D, Patil SP, et al. Interdisciplinary diabetes care: a new model for inpatient diabetes education. Diabetes Spectrum. 2015;28(4):276–82.CrossRef
28.
Zurück zum Zitat Healthwise, available at https://www.healthwise.org/solutions/health-systems.aspx. Accessed May 28, 2019. Healthwise, available at https://​www.​healthwise.​org/​solutions/​health-systems.​aspx.​ Accessed May 28, 2019.
29.
Zurück zum Zitat Shipman JP, Lake EW, Volgen JVD, Doman D. Provider documentation of patient education: a lean investigation. J Med Libr Assoc. 2016;104:154–8.CrossRef Shipman JP, Lake EW, Volgen JVD, Doman D. Provider documentation of patient education: a lean investigation. J Med Libr Assoc. 2016;104:154–8.CrossRef
30.
Zurück zum Zitat Prey JE, Woollen J, Wilcox L, Sackeim AD, Hripcsak G, Bakken S, et al. Patient engagement in the inpatient setting: a systematic review. J Am Med Inform Assoc. 2014;21:742–50.CrossRef Prey JE, Woollen J, Wilcox L, Sackeim AD, Hripcsak G, Bakken S, et al. Patient engagement in the inpatient setting: a systematic review. J Am Med Inform Assoc. 2014;21:742–50.CrossRef
31.
Zurück zum Zitat Smith KM, Baker KM, Bardsley JK, McCartney P, Magee M. Redesigning hospital diabetes education: a qualitative evaluation with nursing teams. J Nurs Care Qual. 2018;34(2):151–7.CrossRef Smith KM, Baker KM, Bardsley JK, McCartney P, Magee M. Redesigning hospital diabetes education: a qualitative evaluation with nursing teams. J Nurs Care Qual. 2018;34(2):151–7.CrossRef
32.
Zurück zum Zitat Youssef G, Ip EH, Magee M, Chen SH, Wallia A, Pollack T, et al. Validity and reliability of a (brief) diabetes “survival skills” knowledge test: KNOW diabetes. Diabetes Educ. 2019, 34(2):151–157.;;45(2):184–93.CrossRef Youssef G, Ip EH, Magee M, Chen SH, Wallia A, Pollack T, et al. Validity and reliability of a (brief) diabetes “survival skills” knowledge test: KNOW diabetes. Diabetes Educ. 2019, 34(2):151–157.;;45(2):184–93.CrossRef
34.
Zurück zum Zitat Orr N, Catsi G, Guirguis N, Balafas A, Rissel C. The use of closed-circuit hospital channel to promote health. The reach and appeal of PPAtv to patients and visitors. Aust Health Rev. 2007;31(4):527–30.CrossRef Orr N, Catsi G, Guirguis N, Balafas A, Rissel C. The use of closed-circuit hospital channel to promote health. The reach and appeal of PPAtv to patients and visitors. Aust Health Rev. 2007;31(4):527–30.CrossRef
35.
Zurück zum Zitat Voltaire. Dictionnaire Philosophique. 1770. Voltaire. Dictionnaire Philosophique. 1770.
Metadaten
Titel
Inpatient Diabetes Education in the Real World: an Overview of Guidelines and Delivery Models
verfasst von
Carine M. Nassar
Alex Montero
Michelle F. Magee
Publikationsdatum
01.10.2019
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 10/2019
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-019-1222-6

Weitere Artikel der Ausgabe 10/2019

Current Diabetes Reports 10/2019 Zur Ausgabe

Pathogenesis of Type 1 Diabetes (A Pugliese and SJ Richardson, Section Editors)

New Evidence of Exocrine Pancreatopathy in Pre-symptomatic and Symptomatic Type 1 Diabetes

Microvascular Complications—Neuropathy (R Pop-Busui, Section Editor)

Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes

Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)

Association Between Antipsychotic Medication Use and Diabetes

Obesity (KM Gadde, Section Editor)

Medical Devices in Obesity Treatment

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.