Early Electronic Specialist-led Diabetes Care Improves Postdischarge Glycemia: The STOIC-D Surgery Follow-up Cohort

Gamage, IL; Barmanray, RD; Kyi, M; Colman, PG; Sun, E; Le, MV; Worth, LJ; Fourlanos, S

Author(s): Gamage, IL; Barmanray, RD; Kyi, M; Colman, PG; Sun, E; Le, MV; Worth, LJ; Fourlanos, S;
Details: Publication Year 2026-01-21,Volume 111,Issue #2,Page e375-e381
Journal Title: Journal of Clinical Endocrinology and Metabolism
Publication Type: Research article
Abstract: OBJECTIVE: To assess the effect of an early, electronic specialist-led model of inpatient diabetes care on glycemic outcomes following discharge and rates of treatment intensification. METHODS: The STOIC-D trial has demonstrated early, electronic specialist-led care by an inpatient diabetes service reduces inpatient hyperglycemia. This follow-up study assessed glycemic outcomes following discharge in a subgroup of 360 STOIC-D trial patients with admission glycated hemoglobin (HbA1c) ≥ 7% and alive 1 year following hospitalization. First available HbA1c between 3 and 15 months following discharge was collected. Multivariable logistic regression identified predictors of clinically significant reduction in HbA1c, defined as ≥0.5%. Multivariable linear regression assessed correlation of baseline characteristics with change in HbA1c. Multivariable logistic regression identified predictors of treatment intensification in hospital. RESULTS: The early intervention arm experienced a greater HbA1c reduction following hospitalization (0.4% [3.9 mmol/mol] vs -0.04% [-0.4 mmol/mol]) compared with preadmission (P = .02). Clinically significant reduction in HbA1c occurred more frequently in the intervention arm (45% vs 31% [P = .01], adjusted odds ratio [aOR] 1.8; 95% CI, 1.1-2.9). Adjusted multivariable linear regression demonstrated inclusion in the intervention arm correlated with proportional reduction in posthospitalization HbA1c. Treatment intensification was more common in the intervention compared with control (36% vs 19% [P = .002], aOR 2.2 [95% CI: 1.3-3.6]). In a subanalysis of participants with admission HbA1c of 7% to 8.5%, age <75 years, the aOR for treatment intensification with early intervention was 4.0 (95% CI, 1.6-11.1). CONCLUSION: Treatment intensification and posthospitalization HbA1c improved following intervention with an early, electronic specialist-led consultation in hospital.
Publisher: Oxford University Press
Keywords: Humans; Male; Female; Middle Aged; Follow-Up Studies; Glycated Hemoglobin/analysis; Aged; Blood Glucose/analysis; Patient Discharge; *Glycemic Control/methods; *Hyperglycemia/prevention & control/blood/therapy; *Diabetes Mellitus, Type 2/therapy/blood; Hospitalization; diabetes mellitus; glycemic control; hyperglycemia management; inpatient diabetes
Department(s): Infectious Diseases
Publisher's Version: https://doi.org/10.1210/clinem/dgaf440
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-08-22 08:45:15

Last Modified: 2026-01-29 05:40:51