OBJECTIVE To explore changes in type 2 diabetes treatment during hospitalization, understand the experiences of providers and patients in managing type 2 diabetes related to hospitalization, and assess type 2 diabetes control postdischarge. RESEARCH DESIGN AND METHODS A convergent mixed methods study used electronic medical record and included a retrospective cohort of adults ≥65 years of age with uncontrolled type 2 diabetes discharged from 11 U.S. hospitals between November 2022 and April 2023. Type 2 diabetes treatment changes included changing diabetes medications or adjusting doses during hospitalization or up to 30 days postdischarge, or completing consults to endocrinology, diabetes education, or nutrition. Type 2 diabetes control was defined as having glycosylated hemoglobin (A1C) 8% at 6 months postdischarge. Logistic regression models assessed the association of treatment change with type 2 diabetes control. Thirty-one semistructured interviews were conducted with a subset of patients (n = 15) and providers (n = 16), with thematic analysis performed. RESULTS The cohort included 358 patients, with a mean (SD) age of 74 (±7) years, 61% White, 95% non-Hispanic, and 51% female. Medication changes occurred in 61% (218 of 358) of patients, and 42% (150 of 358) completed consultations. Type 2 diabetes control was higher in patients with medication changes (versus not) (51% vs. 25%, P = 0.02; unadjusted odds ratio 3.17 95% CI 1.17, 8.54) or completed endocrinology consults (versus not) (unadjusted odds ratio 3.31 95% CI 1.11, 9.97). Most patients and providers supported type 2 diabetes treatment changes during or soon after hospitalization; however, some reported hesitancy, and opportunities for diabetes education were missed. CONCLUSIONS Hospitalization period presents a unique opportunity to treat uncontrolled type 2 diabetes.
Masiano et al. (Tue,) studied this question.