Inpatient diabetes management by specialized diabetes team versus primary service team in non-critical care units: impact on 30-day readmission rate and hospital cost
Open accessAbstract
Objective: We compared the cost-effectiveness of two inpatient diabetes care models: one offered by a specialized diabetes team (SDT) versus a primary service team (PST). Research design and methods: We retrospectively evaluated 756 hospital admissions of patients with diabetes to non-critical care units over 6 months. Out of 392 patients who met the eligibility criteria, 262 were matched 1:1 based on the mean of the initial four blood glucose (BG) values after admission. Primary outcomes were 30-day readmission rate and frequency, hospital length of stay (LOS) and estimated hospital cost. Secondary outcomes included glycemic control and BG variability. Results: Diabetes complexity and in-hospital complications were significantly higher among patients treated by SDT versus PST. Thirty-day readmission rate to medical services was lower by 30.5% in the SDT group versus the PST group (P<0.001), while 30-day readmission rate to surgical services was 5% higher in the SDT group versus the PST group (P<0.05), but frequency of 30-day readmissions was lower (1.1 vs 1.6 times, P<0.05). LOS in medical services was not different between the two groups, but it was significantly longer in surgical services in SDT (P<0.05). However, LOS was significantly lower in patients who were seen by SDT during the first 24 hours of admission compared with those who were seen after that (4.7 vs 6.1 days, P<0.001). Compliance to follow-up was higher in the SDT group. These changes were translated into considerable cost saving. Conclusions: Inpatient diabetes management by an SDT significantly reduces 30-day readmission rate to medical services, reduces inpatient diabetes cost, and improves transition of care and adherence to follow-up. SDT consultation during the first 24 hours of admission was associated with a significantly shorter hospital LOS.
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The increased risk of 30-day readmission following hospitalization that has been attributed to diabetes can be reduced, and costs saved, when inpatient care is provided by a diabetes management team.
“In addition, the increased risk of 30-day readmission following hospitalization that has been attributed to diabetes can be reduced, and costs saved, when inpatient care is provided by a diabetes management team (15,18).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [18]
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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
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Research works printed but not linked: 20
- [3]Fraze T, Jiang HJ, Burgess J Hospital Stays for Patients with Diabetes, 2008: Statistical Brief #93. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville (MD: Agency for Healthcare Research and Quality (US), 2010. 21413213
- [4]Whitston M, Chung S, Henderson J, et al What can be learned about the impact of diabetes on hospital admissions from routinely recorded data? Diabet Med 2012; 29: 1199– 205. 10.1111/j.1464-5491.2011.03535.x 22150293 · DOI
- [5]Menzin J, Korn JR, Cohen J, et al Relationship between glycemic control and diabetes-related hospital costs in patients with type 1 or type 2 diabetes mellitus. J Manag Care Pharm 2010; 16: 264– 75. 10.18553/jmcp.2010.16.4.264 20433217 PMC10437724 · DOI
- [6]Godar DA, Kumar DR, Schmelzer KM, et al The impact of serum glucose on clinical outcomes in patients hospitalized with community-acquired pneumonia. WMJ 2011; 110: 14– 20. 21473508
- [7]Umpierrez GE, Hellman R, Korytkowski MT, et al Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2012; 97: 16– 38. 10.1210/jc.2011-2098 22223765 · DOI · Paper page
- [8]Dungan KM, Binkley P, Nagaraja HN, et al The effect of glycaemic control and glycaemic variability on mortality in patients hospitalized with congestive heart failure. Diabetes Metab Res Rev 2011; 27: 85– 93. 10.1002/dmrr.1155 21218512 PMC3058483 · DOI
- [9]Monnier L, Colette C, Owens DR Glycemic variability: the third component of the dysglycemia in diabetes. Is it important? How to measure it? J Diabetes Sci Technol 2008; 2: 1094– 100. 19885298 PMC2769808
- [10]Al-Dorzi HM, Tamim HM, Arabi YM Glycaemic fluctuation predicts mortality in critically ill patients. Anaesth Intensive Care 2010; 38: 695– 702. 20715734
- [11]Ampudia-Blasco FJ, Ceriello A [Importance of daily glycemic variability in achieving glycemic targets in type 2 diabetes: role of DPP-4 inhibitors]. Med Clin 2010; 135(Suppl 2): 33– 9. 10.1016/S0025-7753(10)70031-2 21420536 · DOI
- [12]Dungan KM, Osei K, Nagaraja HN, et al Relationship between glycemic control and readmission rates in patients hospitalized with congestive heart failure during implementation of hospital-wide initiatives. Endocr Pract 2010; 16: 945– 51. 10.4158/EP10093.OR 20497933 PMC3142926 · DOI
- [13]Kozak LJ, DeFrances CJ, Hall MJ National hospital discharge survey: 2004 annual summary with detailed diagnosis and procedure data. Vital Health Stat 13 2006; 162: 1– 209. 17091747
- [16]Axon RN, Williams MV Hospital readmission as an accountability measure. JAMA 2011; 305: 504– 5. 10.1001/jama.2011.72 21285430 · DOI
- [17]Koproski J, Pretto Z, Poretsky L Effects of an intervention by a diabetes team in hospitalized patients with diabetes. Diabetes Care 1997; 20: 1553– 5. 10.2337/diacare.20.10.1553 9314634 · DOI
- [18]Ostling S, Wyckoff J, Ciarkowski SL, et al The relationship between diabetes mellitus and 30-day readmission rates. Clin Diabetes Endocrinol 2017; 3: 3 10.1186/s40842-016-0040-x 28702257 PMC5472001 · DOI
- [19]Garg R, Schuman B, Bader A, et al Effect of Preoperative Diabetes Management on Glycemic Control and Clinical Outcomes after Elective Surgery. Ann Surg 2017: 1 10.1097/SLA.0000000000002323 28549013 · DOI · Paper page
- [20]Healy SJ, Black D, Harris C, et al Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control. Diabetes Care 2013; 36: 2960– 7. 10.2337/dc13-0108 23835695 PMC3781555 · DOI
- [21]Enomoto LM, Shrestha DP, Rosenthal MB, et al Risk factors associated with 30-day readmission and length of stay in patients with type 2 diabetes. J Diabetes Complications 2017; 31: 122– 7. 10.1016/j.jdiacomp.2016.10.021 27838101 · DOI
- [22]Zekry D, Loures Valle BH, Graf C, et al Prospective comparison of 6 comorbidity indices as predictors of 1-year post-hospital discharge institutionalization, readmission, and mortality in elderly individuals. J Am Med Dir Assoc 2012; 13: 272– 8. 10.1016/j.jamda.2010.11.011 21450226 · DOI
- [23]Chen LM, Jha AK, Guterman S, et al Hospital cost of care, quality of care, and readmission rates: penny wise and pound foolish? Arch Intern Med 2010; 170: 340– 6. 10.1001/archinternmed.2009.511 20177036 · DOI
- [24]Carey K Measuring the hospital length of stay/readmission cost trade-off under a bundled payment mechanism. Health Econ 2015; 24: 790– 802. 10.1002/hec.3061 24803387 · DOI
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Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507 · see citing works
16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
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
The financial impact of an inpatient diabetes management service
Haque, W. Z., Demidowich, A. P., Sidhaye, A., Golden, S. H., & Zilbermint, M. (2021) · Current Diabetes Reports · doi:10.1007/s11892-020-01374-0 · Cited by 48 · see citing works
Predicting and preventing acute care re-utilization by patients with diabetes
Rubin, D. J., & Shah, A. A. (2021) · Current Diabetes Reports · doi:10.1007/s11892-021-01402-7 · Cited by 44 · see citing works
- Authors
- Bansal, V., Mottalib, A., Pawar, T. K., Abbasakoor, N., Chuang, E., Chaudhry, A., Sakr, M., Gabbay, R. A., & Hamdy, O.
- Affiliations
- Hunterdon Medical Center (US)
- Joslin Diabetes Center (US)
- Lahey Hospital and Medical Center (US)
- Stanford Medicine (US)
- University of California, San Francisco (US)
- Emory University (US)
- Corresponding author
- Hamdy, Osama
- Venue
- BMJ Open Diabetes Research & Care
- Publisher
- BMJ
- Published
- 2018-04
- Volume
- 6
- Issue
- 1
- Pages
- e000460
- ISSN
- 2052-4897 (ISSN-L)
- PMC
- PMC5892752
- OpenAlex
- W2795788013
- Cited by
- 91
- References
- 1
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 18 · 2020: 13 · 2019: 13 · 2018: 1
- FWCI
- 8.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open Diabetes Research & Care (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- Joslin Diabetes Center
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK036836)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- inpatient diabetes management, 30-day readmission, hospital costs, cost-effectiveness, length of hospital stay, glycemic control, blood glucose variability, care transitions, follow-up adherence, diabetes complications
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