Recognition and Treatment of Dysglycemia. AGS - Acute Glucose Service
Study Details
Study Description
Brief Summary
AGS (Acute Glucose Service ) is an inpatient glucose management service consisting of Nurse Practitioner and physician. Team manages not - consulted- based preoperative assessment, perioperative glucose control, patient education and supervision, but also transition of care postoperatively. The goal is to detect and treat dysglycemias , but also provide an active and constantly ongoing education to other hospital teams.
AGS improves better overall- survival of arthroplastic patients and is an effective way to recognize and treat dysglycemias and to organize constantly ongoing education.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
600 elective knee and hip arthroplastic patients are collected. 200 patients before AG- service will be compared to 400 patients after AGS. The latter group is divided to two 200 patients groups: 1) with AGS 2) with AGS extended to first control in 3 months (AG- nurse may be contacted by phone). Patients are followed up up to 5 years. Controls will be held after 3 months, 1 year and 5 years after operation including B-Hba1c, 15 D Quality of life assessment and patient interview.
There are several aims of the team and study: to detect, diagnose and optimize treatment (including medication) of diabetic/ dysglycemic patients from preoperative assessment 1 week before operation to postoperative care. With blood glucose target 42 - 86 mmol/mol results better overall survival, lesser complications (i.e. infections, cardiovascular or renal complications) and shorter length of hospital stay. Other aim is to find undiagnosed diabetics or those at risk of developing diabetes. One aim is to find risk factors, which lead to stress hyperglycemia during perioperative period or diabetes in 5 years.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: AG service In the "Active Comparator Arm": Screening, follow-up and treatment of dysglycemias in the elective orthopedic prosthetic surgery (knee / hip) patients in the Päijät-Häme Central hospital will be optimized and individualized in the patients in personal manner. |
Other: AG service
The AG service group is divided to two 200 patients groups: 1) with AGS 2) with AGS extended to first control in 3 months (AG- nurse may be contacted by phone). Patients are followed up up to 5 years.
|
| No Intervention: Without AG service In the "No intervention Arm": Screening, follow-up and treatment of dysglycemias in the elective orthopedic prosthetic surgery (knee / hip) patients follows the current protocol of Päijät-Häme Central hospital. |
Outcome Measures
Primary Outcome Measures
- Survival [1-5 years]
Improved survival
Secondary Outcome Measures
- Complications [1-5 years]
Less complications after AG-service
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patients aged > 18 years
-
Elective knee and hip arthroplasty patients
Exclusion Criteria:
-
Patients who are incompetent to give informed consent
-
Patients who are incompetent to assess their Quality-of-Life personally
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Päijät-Häme Central Hospital | Lahti | Finland | 15850 |
Sponsors and Collaborators
- Joint Authority for Päijät-Häme Social and Health Care
Investigators
- Principal Investigator: Marianne Ylikoski, MD, Päijänne Tavastia Central Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Q321dnro 47/17