Patient understanding of discharge instructions for home diabetes self-management and risk for hospital readmission and emergency department visits
Open accessAbstract
Objective The primary objective of this study was to examine the patient comprehension of diabetes self-management instructions provided at hospital discharge as an associated risk of readmission. Methods Noncritically ill patients with diabetes completed patient comprehension questionnaires (PCQ) within 48 hours of discharge. PCQ scores were compared among patients with and without readmission or emergency department (ED) visits at 30 and 90 days. Glycemic measures 48 hours preceding discharge were investigated. Diabetes Early Readmission Risk Indicators (DERRIs) were calculated for each patient. Results Of 128 patients who completed the PCQ, scores were similar among those with 30-day (n = 31) and 90-day (n = 54) readmission compared with no readmission (n = 72) (79.9 ± 14.4 vs 80.4 ± 15.6 vs 82.3 ± 16.4, respectively) or ED visits. Clarification of discharge information was provided for 47 patients. PCQ scores of 100% were achieved in 14% of those with and 86% without readmission at 30 days (P = .108). Of predischarge glycemic measures, glycemic variability was negatively associated with PCQ scores (P = .035). DERRIs were significantly higher among patients readmitted at 90 days but not 30 days. Conclusion These results demonstrate similar PCQ scores between patients with and those without readmission or ED visits despite the need for corrective information in many patients. Measures of glycemic variability were associated with PCQ scores but not readmission risk. This study validates DERRI as a predictor for readmission at 90 days.
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Providing diabetes self-management education and developing a diabetes discharge plan that includes continued access to diabetes medications and supplies and ongoing education and support are key strategies to improve long-term outcomes.
“In addition, providing diabetes self-management education and developing a diabetes discharge plan that includes continued access to diabetes medications and supplies and ongoing education and support are key strategies to improve long-term outcomes (20,21).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [21]
The Abstract > Conclusion recommends a structured discharge plan for continued diabetes self-management, and the Discussion describes education with postdischarge follow-up. The passages do not establish continued access to medications and supplies as part of that strategy. The Discussion reports outcomes over three months and says whether improvements last longer needs investigation, so the claim about improving long-term outcomes goes beyond this source. (LLM, conf=0.86)
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Cites
Economic Costs of Diabetes in the U.S. in 2002
American Diabetes Association (2003) · Diabetes Care · doi:10.2337/diacare.26.3.917 · Cited by 4,147 · see citing works
Economic Costs of Diabetes in the U.S. in 2017
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dci18-0007 · Cited by 2,528 · see citing works
Economic Costs of Diabetes in the U.S. in 2012
American Diabetes Association (2013) · Diabetes Care · doi:10.2337/dc12-2625 · Cited by 2,153 · see citing works
Hospital Readmissions Reduction Program
McIlvennan, C. K., Eapen, Z. J., & Allen, L. A. (2015) · Circulation · doi:10.1161/circulationaha.114.010270 · Cited by 690 · see citing works
16. Diabetes Care in the Hospital: <i>Standards of Medical Care in Diabetes—2022</i>
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s016 · Cited by 440 · see citing works
15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes—2020
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc20-s015 · Cited by 272 · see citing works
Healy, S. J., Black, D., Harris, C., Lorenz, A., & Dungan, K. M. (2013) · Diabetes Care · doi:10.2337/dc13-0108 · Cited by 211 · see citing works
Lavery, A. M., Preston, L. E., Ko, J. Y., Chevinsky, J., DeSisto, C. L., Pennington, A. F., Kompaniyets, L., Datta, S., Click, E. S., Golden, T., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6945e2 · Cited by 189 · see citing works
Prevalence of Hyper- and Hypoglycemia Among Inpatients With Diabetes
Wexler, D. J., Meigs, J. B., Cagliero, E., Nathan, D. M., & Grant, R. W. (2007) · Diabetes Care · doi:10.2337/dc06-1715 · Cited by 178 · see citing works
Hospital readmission of patients with diabetes
Rubin, D. J. (2015) · Current Diabetes Reports · doi:10.1007/s11892-015-0584-7 · Cited by 159 · see citing works
Self-citationGlucose Variability: A Review of Clinical Applications and Research Developments
Rodbard, D. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2018.0092 · Cited by 154 · see citing works
Umpierrez, G. E., Reyes, D., Smiley, D., Hermayer, K., Khan, A., Olson, D. E., Pasquel, F., Jacobs, S., Newton, C., Peng, L., et al. (2014) · Diabetes Care · doi:10.2337/dc14-0479 · Cited by 130 · see citing works
Risk Factors for Hospitalization in People With Diabetes
Moss, S. E., Klein, R., & Klein, R. (1999) · Archives of Internal Medicine · doi:10.1001/archinte.159.17.2053 · Cited by 112 · see citing works
Wexler, D. J., Beauharnais, C. C., Regan, S., Nathan, D. M., Cagliero, E., & Larkin, M. E. (2012) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2012.09.016 · Cited by 89 · see citing works
Early readmission among patients with diabetes: A qualitative assessment of contributing factors
Rubin, D. J., Donnell-Jackson, K., Jhingan, R. M., Golden, S. H., & Paranjape, A. (2014) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2014.06.013 · Cited by 79 · see citing works
Self-citationHospital Use Among Diabetic Patients and the General Population
Aro, S., Kangas, T., Reunanen, A., Salinto, M., & Koivisto, V. A. (1994) · Diabetes Care · doi:10.2337/diacare.17.11.1320 · Cited by 70 · see citing works
The Effect of Diabetes on Hospital Readmissions
Dungan, K. M. (2012) · Journal of Diabetes Science and Technology · doi:10.1177/193229681200600508 · Cited by 67 · see citing works
Rubin, D. J., Handorf, E. A., Golden, S. H., Nelson, D. B., McDonnell, M. E., & Zhao, H. (2016) · Endocrine Practice · doi:10.4158/e161391.or · Cited by 65 · see citing works
Self-citationDiabetes Transitional Care from Inpatient to Outpatient Setting
Shah, M., Norwood, C. A., Farias, S., Ibrahim, S., Chong, P. H., & Fogelfeld, L. A. (2012) · Journal of Pharmacy Practice · doi:10.1177/0897190012451907 · Cited by 55 · see citing works
Effect of a Hospital-wide Measure on the Readmissions Reduction Program
Zuckerman, R. B., Maddox, K. E. J., Sheingold, S. H., Chen, L. M., & Epstein, A. M. (2017) · New England Journal of Medicine · doi:10.1056/nejmsa1701791 · Cited by 48 · see citing works
Practical Recommendations for Transitioning Patients with Type 2 Diabetes from Hospital to Home
Donihi, A. C. (2017) · Current Diabetes Reports · doi:10.1007/s11892-017-0876-1 · Cited by 43 · see citing works
Self-citationThe Hospital Readmissions Reduction Program
Zuckerman, R. B., Sheingold, S. H., & Epstein, A. M. (2016) · New England Journal of Medicine · doi:10.1056/nejmc1606658 · Cited by 42 · see citing works
The Hospital Readmissions Reduction Program
Gupta, A., & Fonarow, G. C. (2018) · JACC Heart Failure · doi:10.1016/j.jchf.2018.02.012 · Cited by 40 · see citing works
Drincic, A., Pfeffer, E., Luo, J., & Goldner, W. S. (2017) · Journal of Clinical & Translational Endocrinology · doi:10.1016/j.jcte.2017.03.003 · Cited by 38 · see citing works
Magee, M. F., Khan, N. H., Desale, S. Y., & Nassar, C. M. (2014) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721714523684 · Cited by 37 · see citing works
Spanakis, E. K., Umpierrez, G. E., Siddiqui, T., Zhan, M., Snitker, S., Fink, J. C., & Sorkin, J. D. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02575 · Cited by 34 · see citing works
Shrestha, S. S., Zhang, P., HORA, I. A., Geiss, L. S., Luman, E. T., & Gregg, E. W. (2018) · Diabetes Care · doi:10.2337/dc18-1078 · Cited by 33 · see citing works
Dungan, K. M., Osei, K., Nagaraja, H. N., Schuster, D. P., & Binkley, P. F. (2010) · Endocrine Practice · doi:10.4158/ep10093.or · Cited by 32 · see citing works
External Validation of the Diabetes Early Re-Admission Risk Indicator (Derri™)
Rubin, D. J., Recco, D., Turchin, A., Zhao, H., & Golden, S. H. (2018) · Endocrine Practice · doi:10.4158/ep-2018-0035 · Cited by 28 · see citing works
Self-citationClinical Improvement with JAK2 Inhibition in Chuvash Polycythemia
Zhou, A. W., Knoche, E. M., Engle, E. K., Ban‐Hoefen, M., Kaiwar, C., & Oh, S. T. (2016) · New England Journal of Medicine · doi:10.1056/nejmc1600337 · Cited by 27 · see citing works
The Nurse Education and Transition (NEAT) model: educating the hospitalized patient with diabetes
Krall, J. S., Donihi, A. C., Hatam, M., Koshinsky, J., & Siminerio, L. M. (2016) · Clinical Diabetes and Endocrinology · doi:10.1186/s40842-016-0020-1 · Cited by 26 · see citing works
Self-citationRubin, D. J., Golden, S. H., McDonnell, M. E., & Zhao, H. (2017) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.04.021 · Cited by 25 · see citing works
Self-citationHigh diabetes prevalence and insulin medication errors in hospital patients
Taylor, J. E., Campbell, L. V., Zhang, L., & Greenfield, J. R. (2018) · Internal Medicine Journal · doi:10.1111/imj.14124 · Cited by 24 · see citing works
Medication errors at hospital admission and discharge in Type 1 and 2 diabetes
Breuker, C., Macioce, V., Mura, T., Audurier, Y., Boegner, C., Jalabert, A., Villiet, M., Castet‐Nicolas, A., Avignon, A., & Sultan, A. (2017) · Diabetic Medicine · doi:10.1111/dme.13531 · Cited by 22 · see citing works
Emons, M. F., Bae, J. P., Hoogwerf, B. J., Kindermann, S. L., Taylor, R., & Nathanson, B. H. (2016) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2015-000160 · Cited by 16 · see citing works
Spanakis, E. K., Singh, L. G., Siddiqui, T., Sorkin, J. D., Notas, G., Magee, M. F., Fink, J. C., Zhan, M., & Umpierrez, G. E. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000990 · Cited by 10 · see citing works
Validation and Comparison of Two 30-Day Re-Admission Prediction Models in Patients with Diabetes
Alamer, A., Patanwala, A. E., Aldayyen, A. M., & Fazel, M. T. (2019) · Endocrine Practice · doi:10.4158/ep-2019-0125 · Cited by 9 · see citing works
Korytkowski, M. T., Karslioglu French, E., Brooks, M., DeAlmeida, D., Kanter, J., Lombardero, M., Magaji, V., Orchard, T., & Siminerio, L. (2016) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2016-000206 · Cited by 6 · see citing works
Self-citationThe futile cycle of hospital readmission in patients with diabetes
Swami, J., & Korytkowski, M. T. (2017) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.06.006 · Cited by 5 · see citing works
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16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2023
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D. M., Johnson, E. L., et al. (2022) · Diabetes Care · doi:10.2337/dc23-s016 · Cited by 226 · see citing works
16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2025
ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Early, K. B., Bruemmer, D., Echouffo-Tcheugui, J. B., Ekhlaspour, L., Galindo, R. J., et al. (2024) · Diabetes Care · doi:10.2337/dc25-s016 · Cited by 225 · see citing works
16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2024
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Galindo, R. J., Hilliard, M. E., Johnson, E. L., Khunti, K. K., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s016 · Cited by 185 · see citing works
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American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
Patel, N., Swami, J., Pinkhasova, D., French, E. K., Hlasnik, D. S., Delisi, K., Donihi, A. C., Siminerio, L. S., Rubin, D. J., Wang, L., et al. (2022) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2021-002722 · Cited by 10 · see citing works
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Golden, B. P., & Okrainec, K. (2022) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2022.12.001 · Cited by 1 · see citing works
Stationäre Patienten mit der Nebendiagnose Diabetes mellitus: Managementkonzepte
Pietsch, C., & Jenssen, C. (2022) · Die Diabetologie · doi:10.1007/s11428-022-00898-1
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Ragasritha, K., Satwika, B., Reddy, E., Yugandhar, M., & Swain, N. K. (2025) · International Conference on Computational Intelligence and Communication Technologies (CCICT) · doi:10.1109/ccict65753.2025.00031
Li, L., & Jiang, S. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1827506
Song, J., Makhdzir, N., Haron, Z., Qin, C., & Wang, L. (2026) · Patient Preference and Adherence · doi:10.2147/ppa.s626817
Self-citation
- Authors
- Pinkhasova, D., Swami, J. B., Patel, N., Karslioglu-French, E., Hlasnik, D. S., Delisi, K. J., Donihi, A. C., Rubin, D. J., Siminerio, L. S., Wang, L., & Korytkowski, M. T.
- Affiliations
- University of Pittsburgh Medical Center (US)
- NYU Langone Health (US)
- University of Pittsburgh (US)
- Temple University (US)
- Corresponding author
- Korytkowski, Mary T.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2021-06
- Volume
- 27
- Issue
- 6
- Pages
- 561-566
- ISSN
- 1530-891X (ISSN-L)
- PMC
- PMC10877970
- OpenAlex
- W3144847935
- Cited by
- 9
- References
- 39
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 4
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Endocrine Society (NCT03279627)
- National Institutes of Health (UL1-TR-001857)
- American Diabetes Association
- AstraZeneca
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- diabetes self-management, patient understanding, hospital readmission, emergency department visits, glycemic variability
- MeSH terms
- Self-Management, Diabetes Mellitus, Emergency Service, Hospital, Humans, Patient Discharge, Patient Readmission, Retrospective Studies
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