Instituting a successful discharge plan for patients with type 2 diabetes: challenges and solutions
Open accessAbstract
Achieving target inpatient glycemic management outcomes has been shown to influence important clinical outcomes such as hospital length of stay and readmission rates. However, arguably the most profound, lasting impact of inpatient diabetes management is achieved at the time of discharge—namely reconciling and prescribing the right medications and making referrals for follow-up. Discharge planning offers a unique opportunity to break through therapeutic inertia, offer diabetes self-management education, and institute an individualized treatment plan that prepares the patient for discharge and promotes self-care and engagement. However, the path to a successful discharge plan can be fraught with potential pitfalls for clinicians, including lack of knowledge and experience with newer diabetes medications, costs, concerns over insurance coverage, and lack of time and resources. This article presents an algorithm to assist clinicians in selecting discharge regimens that maximize benefits and reduce barriers to self-care for patients and a framework for creating an interdisciplinary hospital diabetes discharge program.
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The post-hospitalization period is critical for diabetes care: gaps in follow-up, medication mismanagement, or worsening conditions can precipitate acute complications and costly ED visits.
“The post-hospitalization period is critical for diabetes care: gaps in follow-up, medication mismanagement, or worsening conditions can precipitate acute complications and costly ED visits [7,10–12].”
From Machine learning-driven risk prediction for post-hospitalization diabetes case management: Integrating clinical and social determinants of health (2026) · cites this paper as [12]
The paper’s opening section (page unavailable) emphasizes discharge medications and follow-up, identifies worsening conditions as a reason to adjust treatment, and links diabetes-related readmissions to financial implications. Its outpatient education section also calls continued care after discharge essential. These passages support the importance of the post-hospitalization period, but they do not specifically say that the listed gaps precipitate acute complications and costly ED visits. (LLM, conf=0.84)
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Goldenberg, R. (2013) · Current Medical Research and Opinion · doi:10.1185/03007995.2013.852078 · Cited by 17 · see citing works
Hellmund, R., Weitgasser, R., & Blissett, D. B. (2018) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2018.14.2.86 · Cited by 17 · see citing works
BAJAJ, H. S., Aronson, R., Venn, K., Ye, C., & Sharaan, M. E. (2015) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2015.07.004 · Cited by 16 · see citing works
Hospital Diabetes Meeting 2020
Umpierrez, G. E., Rushakoff, R. J., Seley, J. J., Zhang, J. Y., Shang, T., Han, J. L., Spanakis, E. K., Alexanian, S. M., Drincic, A., Kulasa, K. M., et al. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820939626 · Cited by 15 · see citing works
Self-citationDiabetes Champions: Culture Change Through Education
Jornsay, D. L., & Garnett, E. D. (2014) · Diabetes Spectrum · doi:10.2337/diaspect.27.3.188 · Cited by 15 · see citing works
Practical guidance for use of oral semaglutide in primary care: a narrative review
Morales, J., Shubrook, J. H., & SKOLNIK, N. (2020) · Postgraduate Medicine · doi:10.1080/00325481.2020.1788340 · Cited by 14 · see citing works
The Endocrine Hospitalist: Enhancing the Quality of Diabetes Care
Zilbermint, M. F. (2021) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211007908 · Cited by 14 · see citing works
Self-citationAbles, A. Z., Bouknight, P., Bendyk, H. A., Beagle, R., Alsip, R., & Williams, J. J. (2016) · Journal for Healthcare Quality · doi:10.1097/jhq.0000000000000023 · Cited by 14 · see citing works
Kalra, S., Deepak, M., Narang, P., Singh, V., Uvaraj, M. G., & Agrawal, N. K. (2013) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2012.0237 · Cited by 13 · see citing works
Insulin in America: A Right or a Privilege?
Hirsch, I. B. (2016) · Diabetes Spectrum · doi:10.2337/diaspect.29.3.130 · Cited by 13 · see citing works
Building a Business case for Inpatient Diabetes Management Teams: Lessons from our Center
Sidhaye, A. R., Mathioudakis, N. N., Bashura, H., Sarkar, S., Zilbermint, M. F., & Golden, S. H. (2019) · Endocrine Practice · doi:10.4158/ep-2018-0471 · Cited by 13 · see citing works
Self-citationGarry, E. M., Buse, J. B., Gokhale, M., Lund, J. L., Nielsen, M. E., Pate, V., & Stürmer, T. (2019) · Diabetes Obesity and Metabolism · doi:10.1111/dom.13774 · Cited by 12 · see citing works
Development of a DiaBEATes Nurse Champion Program
Uplinger, N., Turkel, M. C., Adams, P. C., Nelson-Slemmer, D., & Pierce, S. T. (2009) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721709340804 · Cited by 11 · see citing works
Shelton, C., Demidowich, A. P., Motevalli, M., Sokolinsky, S., MacKay, P., Tucker, C., Abundo, C., Peters, E., Gooding, R., Hackett, M., et al. (2021) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211008513 · Cited by 11 · see citing works
Self-citationHirsch, I. B., Buse, J. B., Leahy, J. L., McGill, J. B., Peters, A. L., Rodbard, H. W., Rubin, R. R., Skyler, J. S., Verderese, C. A., & Riddle, M. C. (2013) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12136 · Cited by 10 · see citing works
Cardiovascular safety outcomes of once‐weekly GLP‐1 receptor agonists in people with type 2 diabetes
Goldman, J. D. (2020) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1111/jcpt.13226 · Cited by 10 · see citing works
Revisiting The Use of Pioglitazone in the Treatment of Type 2 Diabetes
EINHORN, D. F., & Fonseca, V. A. (2016) · Endocrine Practice · doi:10.4158/ep161409.co · Cited by 8 · see citing works
Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors
Kataria, A., & Argyropoulos, C. (2022) · Springer eBooks · doi:10.1007/978-3-030-86020-2_25 · Cited by 6 · see citing works
Božek, T., Bilić-Čurčić, I., Berković, M. C., Gradišer, M., Kurir, T. T., Majanović, S. K., & Marušić, S. (2018) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-018-0321-x · Cited by 5 · see citing works
Treatment Outcomes of Graded Dose of Empagliflozin in Type-2 Diabetes
Dutta, D., Sharma, M., Aggarwal, S., Aggarwal, A., & Dhall, A. (2022) · Annals of African Medicine · doi:10.4103/aam.aam_69_20 · Cited by 5 · see citing works
How to win customers and influence people: Ameliorating the barriers to inducing behavioural change
Markey‐Towler, B. (2017) · RePEc: Research Papers in Economics · Cited by 2 · see citing works
Readmission and Comprehension of Diabetes Education at Discharge (ReCoDED Study)
Swami, J., Donihi, A. C., Siminerio, L. M., French, E. K., Delisi, K., Hlasnik, D. S., Patel, N., Pinkhasova, D., Rubin, D. J., & Korytkowski, M. T. (2018) · Diabetes · doi:10.2337/db18-147-lb · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 117 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Scheen, A. J. (2023) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2023.2279193 · Cited by 11 · see citing works
Demidowich, A. P., Stanback, C., & Zilbermint, M. F. (2024) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.15190 · Cited by 9 · see citing works
Self-citationManagement of Hyperglycemia in Hospitalized Patients
Gianchandani, R. Y., Wei, M., & Demidowich, A. P. (2024) · Annals of Internal Medicine · doi:10.7326/annals-24-02754 · Cited by 8 · see citing works
Self-citationDost, L. S., Gastaldi, G., & Schneider, M. P. (2025) · Pharmacy · doi:10.3390/pharmacy13030064 · Cited by 5 · see citing works
Transformer-Based Prediction of Hospital Readmissions for Diabetes Patients
García-Mosquera, J., Villa-Monedero, M., Gil-Martín, M., & San-Segundo, R. (2025) · Electronics · doi:10.3390/electronics14010174 · Cited by 4 · see citing works
Kumar, N., Knight, A. M., Demidowich, A. P., Stanback, C., Bashura, H., Hussain, Q., Gonzales, E. H., Funk, J., Motevalli, M., & Zilbermint, M. F. (2025) · Journal of Diabetes Science and Technology · doi:10.1177/19322968251370754 · Cited by 2 · see citing works
Self-citationAgvall, B., & Jonasson, J. M. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-096633 · Cited by 2 · see citing works
Lee, S.-Y., Saleem, M., Land, A. M., DeLaney, E. W., Garretson, A. R., Patel, M., Hall, A. G., Westrick, S., Ovalle, F., Cherrington, A. L., et al. (2026) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2026.106604
Barriers to Diabetes Care at Hospital Discharge
Gordon, C., Nelson, H., & Perez-Vilbon, K. (2023) · Contemporary Endocrinology · doi:10.1007/978-3-031-44648-1_30
Lee, S.-Y., Saleem, M., Land, A. M., Delaney, E. W., Garretson, A., Patel, M., Hall, A. G., Westrick, S. C., Ovalle, F., Cherrington, A., et al. (2025) · doi:10.2196/preprints.72624
Purnama, A. D., Yueniwati, Y., Dina, D. S. L. I., Kristianto, H., Irawan, P. L. T., Rosandi, R., & Anggreni, N. K. I. S. (2025) · Journal of Foot and Ankle Surgery (Asia Pacific) · doi:10.5005/jp-journals-10040-1417
Use of semaglutide after acute coronary syndrome: an exploratory retrospective study
Biasin, M., Stratinaki, M., Cordioli, N., Armani, I., Giovanni, S. D., Aletras, G., Betta, D., Callegarin, L., Gambaro, A., & Morani, G. (2026) · Journal of Cardiovascular Medicine · doi:10.2459/jcm.0000000000001837
Breslin, K. A., Marx, A., Sokolinsky, S., BUROMETTO, L., Mathioudakis, N. N., Bashura, H., Gonzales, E., Stanback, C., Zilbermint, M. F., & Demidowich, A. P. (2026) · Endocrine Practice · doi:10.1016/j.eprac.2026.03.006
Self-citationChen, H., Lu, X., Shu, T., Liang, M., Li, M., & Xie, H. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1809536
Magamba, B., Jonasson, J. M., Pettersson, L., Halling, A., & Agvall, B. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-08386-7
- Authors
- Demidowich, A. P., Batty, K., & Zilbermint, M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Demidowich, Andrew P.
- Venue
- Diabetes Spectrum
- Publisher
- American Diabetes Association
- Published
- 2022-11-01
- Volume
- 35
- Issue
- 4
- Pages
- 440-451
- ISSN
- 1040-9165 (ISSN-L)
- 1944-7353
- PMC
- PMC9668725
- OpenAlex
- W4309218849
- Cited by
- 15
- References
- 117
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 2 · 2023: 2
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Spectrum (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, discharge planning, glycemic control, medication reconciliation, diabetes self-management education, hospital readmission, therapeutic inertia, antidiabetic drugs, insurance coverage barriers, personalized treatment planning
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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