1023-P: Predictive Value of Admission Plasma Glucose and Hemoglobin A1c on Inpatient Glycemic Control Assessed by Continuous Glucose Monitoring (CGM) in Medicine and Surgery Persons with Diabetes

Predictive Value of Admission Plasma Glucose and Hemoglobin A1c on Inpatient Glycemic Control Assessed by Continuous Glucose Monitoring (CGM) in Medicine and Surgery Persons with Diabetes

To determine the predictive value of admission blood glucose (BG) and A1C on inpatient glycemic control assessed by CGM in general medicine and surgery persons with T2D, we combined data from two randomized controlled trials of insulin-treated patients wearing a Dexcom G6 CGM. The primary outcome was optimal glycemic control defined as the percent time in range (TIR, 70-180 mg/dL) ≥70% without hypoglycemia (<70 mg/dL). Logistic regression models were used to evaluate the predictive role of admission BG < 180, 181-250, and >251 mg/dL as well as A1C (<7, 7-9, and >9%).

Among 262 persons (medicine 73%, admission BG 222.4±121 mg/dL, A1C 9.4±2.4%), good glycemic control was achieved in 24%, 7.7%, and 7.5% of patients with admission BG <180, 181-250 and >251 mg/dL; and in 26%, 19%, and 8.6% in those with admission A1C <7%, 7-9%, and >9%, respectively. There were no differences in the rate of hypoglycemia, length of hospital stay (LOS), or hospital complications, Table.

Conclusion: Persons with higher admission BG and HbA1c levels had lower odds of achieving good glucose control (TIR 70-180 mg/dL ≥70% without hypoglycemia); however, there were no differences in hypoglycemia, LOS, or hospital complications compared to those with admission glucose <180 mg/dl or HbA1c <7%.

Table. Hospital glycemic control according to admission glucose and A1C values.

*Good Control: Mean daily glucose 70-180 mg/dL, without hypoglycemia < 70 mg/dLTIR: Time in range; TAR: time above range; TBR: time below range; LOS: length of stay