Frequent glucose monitoring prevents hypoglycemia, death in hospitalized patients with CVD

Shuyang Fang

CHICAGO — Patients hospitalized with stable coronary artery disease but without diabetes are more likely to experience lower inpatient mortality, shorter hospital stays and reduced health care costs when their blood glucose is monitored at least 3 times daily, according to data presented at the Endocrine Society Annual Meeting.

“Interestingly, patients without preexisting diabetes have a higher incidence of low blood sugar levels during a hospital stay compared with those with diabetes,” Shuyang Fang, MD, endocrinology resident at the Icahn School of Medicine at Mount Sinai, New York, told Endocrine Today. “The underlying explanation for this unusual phenomenon is that diabetic patients admitted to an acute care hospital are routinely monitored closely with blood glucose readings 3 to 4 times a day; however, nondiabetic patients are often overlooked regarding glucose monitoring.”

Fang and colleagues analyzed data from the National Inpatient Sample database on 1,262,943 patients admitted to acute care hospitals in the United States with stable coronary artery disease in 2014. Within the cohort, 3,000 (0.24%) experienced an episode of hypoglycemia during their inpatient stay. Patients experiencing hypoglycemia were more likely to be women vs. men (47% vs. 39%), live in poverty and have features indicating renal failure or heart failure, but were less likely to have diabetes vs. patients who did not experience a hypoglycemia episode, according to the researchers.

When the researchers compared patients who did and did not experience hypoglycemia while in the hospital, those with a hypoglycemia episode experienced higher inpatient mortality (OR = 4.48), longer hospital stays (mean, 7 days vs. 5.3 days) and increased mean health care costs associated with their stay (mean, $70,957 vs. $57,275). Results persisted after adjustment for age, sex, race, income and diabetes, HF and renal failure status, according to researchers.

“Frequent monitoring of finger stick glucose levels in hospitalized heart disease patients to avoid low blood sugar could be potentially lifesaving,” Fang said. “Even among patients without preexisting diabetes, who are often overlooked for the importance of glucose monitoring, at least once-a-day fingerstick glucose monitoring could be beneficial.” – by Regina Schaffer

Reference:

Fang S, et al. SAT-108. Presented at: The Endocrine Society Annual Meeting; March 17-20, 2018; Chicago.

Disclosure: Fang reports no relevant financial disclosures.