Reduction of hospital costs and length of stay by good control of blood glucose levels

Objective: To discuss the available literature regarding the potential benefits of improving blood glucose control in hospitalized patients. Results: Subjects with diabetes constitute an increasing proportion of hospitalized patients. Hospital costs attributable to diabetes are in excess of $40 billion annually in the United States. Numerous reports have confirmed a correlation between blood glucose control at the time of hospitalization and adverse inpatient outcomes for various admission diagnoses, in some cases with or without a previous diagnosis of diabetes. Several studies have specifically found a relationship between improved inpatient control of blood glucose levels and decreased hospital length of stay. Likewise, cost savings have been proposed for intensive inpatient glucose management for a few critical admission diagnoses. Although the apparent economic advantage of aggressive control of blood glucose levels is substantial, cost-effectiveness analyses have been few and limited in scope. Conclusion: Improved blood glucose control in the hospital setting appears to reduce the duration of hospital stay and the hospital costs. Comprehensive analyses of cost-effectiveness through prospective, randomized intervention trials are needed, however, to characterize these benefits more precisely.