{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:03:51Z","timestamp":1784113431860,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,1,21]],"date-time":"2013-01-21T00:00:00Z","timestamp":1358726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the association of in\u2010hospital diabetes regimen intensification with subsequent 30\u2010day risk for unplanned readmission\/emergency department admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively studied 1949 adults with Type\u00a02 diabetes receiving primary care within an academic health network admitted to the hospital between January 2007 and December 2009. Glucose therapy intensification was defined as new start of insulin or oral hypoglycaemic agents, or addition of prandial insulin or insulin mixtures. The association of glucose therapy intensification with subsequent 30\u2010day risk for unplanned readmission\/emergency department admission was examined, with focus on medicine service patients with poorly controlled glycaemia (baseline HbA<jats:sub>1c<\/jats:sub> \u2265\u00a064\u00a0mmol\/mol).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One in six patients (324\/1949, 17%) had early readmission\/emergency department admission. Compared with patients without early readmission, readmitted patients were more often male (58 vs. 52%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), had higher Charlson co\u2010morbidity score [mean (<jats:sc>sd<\/jats:sc>) 3.0 (2.0) vs. 2.8 (1.8), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02], longer length of stay [5 (4.4) vs. 3.9 (3.3) days, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01] and were more often discharged home with nursing services (38 vs. 32%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). Overall, glucose therapy intensification was not associated with early hospital readmission\/emergency department admission (odds ratio\u00a00.94, 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.64\u20131.37, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.74). However, among medicine service patients with baseline HbA<jats:sub>1c<\/jats:sub> \u2265\u00a064\u00a0mmol\/mol (8%), glucose therapy intensification was associated with a significantly decreased early readmission risk (adjusted odds ratio\u00a00.33, 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.12\u20130.88, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03) and lower post\u2010discharge HbA<jats:sub>1c<\/jats:sub> {mean decrease (<jats:sc>sd<\/jats:sc>): 20 (26) mmol\/mol [1.8 (2.4)%] vs. 7 (15) mmol\/mol [0.6 (1.4)%], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01}.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diabetes medical regimen intensification during hospitalization was not associated with early readmission. Among patients with elevated HbA<jats:sub>1c<\/jats:sub>, glucose therapy intensification was associated with a decreased 30\u2010day readmission\/emergency department admission risk and lower outpatient HbA<jats:sub>1c<\/jats:sub> levels. Our findings support the safety and durable impact of diabetes regimen optimization during hospital admission.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12061","type":"journal-article","created":{"date-parts":[[2012,11,6]],"date-time":"2012-11-06T04:28:25Z","timestamp":1352176105000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Intensification of diabetes medication and risk for 30\u2010day readmission"],"prefix":"10.1111","volume":"30","author":[{"given":"N. 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W.","family":"Grant","sequence":"additional","affiliation":[{"name":"Kaiser Permanente, Division of Research Oakland CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,21]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-1151"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-1090"},{"key":"e_1_2_5_4_1","first-page":"553","volume-title":"Diabetes in America","author":"Aubert RE","year":"1995"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.350"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.8.1371"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810625"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.3.8341"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-0295"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.535732"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01354-0"},{"key":"e_1_2_5_12_1","unstructured":"Institute for Safe Medication Practices.ISMP's List of High\u2010Alert Medications.2008. 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