Identifying Trends in Glycemic Management in the Acute Cancer Care Center at MD Anderson Cancer Center.

Hyperglycemia in the inpatient setting contributes to morbidity and mortality. Glycemic management in the emergency room setting is the initial gateway for inpatient management. We gathered baseline glycemic data from January 2019 through November 2022 from the ACCC (Acute Cancer Care Center) at MD Anderson Cancer Center. For patients presenting to the ACCC between 2019 and 2022, the percentage with initial glucose level of 200-249mg/dL ranged from 6.64% to 7.5%, 3.33% to 6.4% with 250-299mg/dL, and 2% to 2.3% with of 300mg/dL or greater. 57.27% to 61.25% of patients were admitted inpatient and 20.67% to 29.73% were admitted with a POC glucose. Of those with known diabetes mellitus, 22.17% to 27% presented with an initial glucose of 200-249mg/dL, 12.17 % to 14% with 250 to 299mg/dL, and 6.92% to 8.75% with 300mg/dL or greater. Of those patients, 61.58% to 67.25% were admitted inpatient. In 2019, 48.9% of diabetes patients had a POC glucose order on admission compared to 39.08% in 2020, 43.17% in 2021, and 52.18% in 2022. In 2019, 76% had an insulin order on admission, 67.25% in 2020, 64.75% in 2021, and 63.09% in 2022. Of those patients with known diabetes 36.92% were admitted with an insulin sliding scale order in 2019, 25.58% in 2020, 26.17% in 2021, and 35.64% in 2022. Over the four years, the average initial blood glucose remained stable across both the general and diabetes specific populations. The admission rate for both these populations also had little variability. Of the patients with diabetes, the rate of POC glucose order at admission increased significantly from 39.08% to 52.18%. However, those with an insulin order decreased steadily from 76% to 63%. Additionally, only 25.58% to 36.92% of patients with diabetes were admitted with an insulin sliding scale order. These trends provide valuable insight into areas that may be targeted for early intervention in glycemic management which has the potential to improve hospital outcomes in patients with diabetes mellitus. [ABSTRACT FROM AUTHOR]