High Glucose Variability Increases 30-Day Readmission Rates in Patients with Type 2 Diabetes Hospitalized in Department of Surgery

Abstract

Glucose variability is common among hospitalized patients with type 2 diabetes mellitus (DM). I investigated to assess the variability of glucose in patients with type 2 DM accounts for in-hospital readmission rates in department of Surgery. I retrospectively analyzed 206 patients with type 2 DM, who was admitted to our hospital for surgical interventions and re-admitted within 30 days after discharge. I also enrolled 610 age, sex and diabetic duration matched patients with type 2 DM, as control. Outcomes measure included average and standard deviation (SD) of blood glucose during admission, glycated hemoglobin (HbA1c), lipid profile, renal function, length of stay (LOS). Patients who had re-admission within 30 days after discharge had higher SD of blood glucose levels than control (84.7 ± 53.5 mg/dL vs. 46.2 ± 42.8 mg/dL, p < 0.001) but not average of blood glucose levels. Comparing to control group, the study group also had higher HbA1c (8.4 ± 1.3% vs. 7.7 ± 1.1%, p = 0.015) and LOS (8.5 ± 2.5 days vs 7.0 ± 1.5 days, p = 0.020). The independent predictors of 30-day readmission rates were SD of blood glucose during admission and HbA1c (hazard ratio: 1.680, 1.493; p value < 0.001, 0.008, respectively). Decreasing glucose variability during admission for surgery is important for patients with type 2 DM to decreasing re-admission rates and LOS. HBA1c may also identify patients at higher risk of postoperative complications and possibility of re-admission.