N019 Implementation of an Integrated Diabetes Management Program Within a Cardiac Care Institution: Pre and Post Program Implementation Results

Abstract

The epidemic of diabetes continues to flourish in Canada and throughout the world. This epidemic is no where more apparent than in the in-patient hospital setting. Cardiovascular disease remains to be the leading cause of death in individuals with diabetes and occurs two to four fold more often than in nondiabetics (Clinical Practice Guidelines 2008). Within our tertiary cardiac care institution, approximately fifty percent of in-patients are diagnosed with diabetes; ten to fifteen percent are newly diagnosed upon admission to hospital. Patients with a preexisting diagnosis of diabetes experience a 2.7fold increase in risk of in-hospital mortality, while those newly diagnosed have an 18fold increase compared to patients with normoglycemia (Fowler, 2009). A multitude of evidence exists linking high glucose levels with increased resource use and worse clinical outcomes in patients with cardiovascular disease. Diabetes education and management skills are the forefront of managing diabetes. Hospitalization is a unique opportunity for health care providers to provide patients with evidenced based diabetes care. A systematic and integrated diabetes management program was implemented in our acute cardiac institution based on best practice guidelines. This presentation will focus on comparing pre program or baseline data with post program implementation outcomes. Study results will demonstrate the feasibility and effectiveness of a diabetes management program within a tertiary in-patient environment, a paradigm shift from the traditional primary models. Health outcomes depend on patients managing this chronic disease effectively, reducing complications, improving quality of life and decreasing hospital readmissions.