SOURCE: American Association of Clinical Endocrinologists

March 14, 2007 09:48 ET

New Research May Help Pave the Way for Shorter Hospital Stays for Patients With Diabetes

SEATTLE, WA -- (MARKET WIRE) -- March 14, 2007 -- Protocol-driven insulin therapy on the medical-surgical wards resulted in better glucose control, as compared to individualized management in patients with diabetic foot ulcers. As a result, shorter hospital stays may be possible. These new findings will be presented at the American Association of Clinical Endocrinologists (AACE) Sixteenth Annual Meeting and Clinical Congress, which will be held April 11 - 15 at the Washington State Convention & Trade Center in Seattle.

"This is the first randomized pilot trial to showcase how intensive subcutaneous insulin protocol on medical-surgical wards can help to improve diabetes control," Alicia Leung, MD, at Stroger Hospital of Cook County in Chicago said. "Diabetes clinical pathway applied to routine management of surgical patients on the wards of public hospitals resulted in superior glucose control."

A group of 23 patients with type 2 Diabetes Mellitus were admitted for surgical management of diabetic foot ulcers. Once routine medical consultation for preoperative evaluation of high glucose was requested, patients were randomly assigned to a medical consult physician providing individualized glycemic management or medical consult physician trained in protocol-driven subcutaneous insulin therapy twice a day.

"Those patients who received the protocol-driven insulin therapy were in the hospital roughly 2.5 days less than those who received the individualized glycemic management, discharge decisions being made by a surgical team based on wound healing and regardless of glucose control," Dr. Leung said. "This clinically significant difference eventually supported implementation of hospital-wide subcutaneous insulin protocol at Stroger Hospital, limiting the size of our study -- thus we were able to show only a marginal statistical significance. Optimal glucose control is known to improve wound healing and also make diabetic patients less susceptible to bacterial infections."

"Our study shows that protocol-driven insulin therapy results in a better glycemic outcome, improving the quality of care and achieving standard of care goals," Dr. Leung said.

"Endocrinology expertise is important in implementing and trouble-shooting insulin protocol, identifying patients that do not fit standard care," Dr. Jurado, currently a hospitalist at Saint Luke's Hospital in Jacksonville, FL, said. "However, hyperglycemia being the fourth most common co-morbid condition in the hospital, clinical pathways for glucose management can be successfully delivered by hospitalists and house staff physicians."

This original research is being presented by Alicia Leung, MD, and Gustavo A. Jurado, MD, in collaboration with Ikna Espinosa, DO, Sylvia Velinova, MD, and Rasa Kazlauskaite, MD, FACE. The study took place at the Stroger Hospital of Cook County in Chicago.

This study will be featured as part of a poster session held during the 16th Annual Meeting and Clinical Congress. Members of the press are invited to attend poster preview sessions on Thursday, April 12, and Friday, April 13, 2007, from 9:00 a.m. to 9:45 a.m. The preview sessions will be located in the Sheraton Exhibit Hall 4E in Seattle. Dr. Leung will be in the Media Room to discuss these findings on Friday, April 13, 2007, from 12:00 p.m. to 1:00p.m.

Media Registration

Media Registration is available free of charge to members of the working media. Online registration is available at http://www.aace.com/meetings/ams/2007/MRGuidelines.php or by contacting Greg Willis at the AACE Public & Media Relations department at 904-353-7878 ext. 147. During the 16th Annual Meeting and Clinical Congress, the Media Room will be open from 8:00 a.m. to 5:00 p.m. from Wednesday, April 11 through Saturday, April 14, 2007.

About AACE

AACE is a professional medical organization with more than 6,000 members in the United States and 84 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE initiatives inform the public about endocrine disorders. AACE also conducts continuing education programs for clinical endocrinologists, physicians whose advanced, specialized training enables them to be experts in the care of endocrine disease, such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity. For further information about AACE and the Annual Meeting, visit the AACE web site at www.aace.com.

About the AACE Annual Meeting

The Sixteenth Annual Meeting of AACE is structured to provide relevant clinical information for the practicing endocrinologist. The programs will focus on information that allows endocrinologists to achieve the best solutions for the diagnosis and management of endocrine diseases. Pertinent scientific, clinical practice and patient management will be disseminated via general sessions, workshops, meet-the-experts and satellite symposia.

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