Effects of Counseling and Implementation of Clinical Pathway on Diabetic Patients Hospitalized with Hypoglycemia
Paiboon Kampan MD*
Affiliation : * Section of Medicine, Taksin Hospital
Objectives : A prospective randomized controlled study was conducted to examine the effects of counseling
and implementation of clinical pathway on type 2 diabetic patients hospitalized with hypoglycemia.
Materials and Methods : Thirty- three cases received counseling and clinical pathway for treatment of hypogly-
cemia (study group) and another 32 cases received conventional treatment for hypoglycemia (control group)
in Taksin Hospital between July and December 2005.
Results : Both groups have similar age, sex, and mean serum glucose on admission. There were also no
differences between the two groups in terms of number of patients with chronic diabetic complications, acute
concurrent illness and pattern of hypoglycemic drugs used for treatment. Average length of hospital stay of the
study group was significantly lower than that of the control group (3.94 (cid:31) 1.03 vs 6.38 (cid:31) 4.05; p = 0.0005).
There were also a significant decrease in the mean number of capillary blood glucose tests performed in the
study group compared to the control group (10.03 (cid:31) 5.04 vs 12.34 (cid:31) 5.96; p = 0.048). Subsequent re-
admissions with recurrent hypoglycemia at 1 and 3 months interval after being discharged from the hospital
decreased significantly in the study group (6.06 % vs 34.38 %; p = 0.036). While there was considerable
reduction in mean medical cost in the study group, it did not reached a statistically significant difference when
compared with the control group ( 2,743.58 (cid:31) 1,473.04 vs 3,687 (cid:31) 3,110.82; p = 0.06).
Conclusion : Counseling and implementation of clinical pathway on type 2 diabetic patients hospitalized
with hypoglycemia can reduce the length of hospital stay and decrease readmission rates of recurrent
hypoglycemia. This results in considerable health and economic benefits.
Keywords : Counseling, Clinical pathway, Type 2 diabetes mellitus, Hypoglycemia, Length of hospital stay
