Transitioning to Outpatient Care

Strategies for Effective Discharge Planning for Hospitalized Patients With Diabetes

Key Points

  • Upon admission (or as soon thereafter as possible), every patient’s need for diabetes education should be assessed.

  • During hospital stay, all patients with diabetes should receive necessary training in diabetes knowledge and self-care skills.

  • Upon discharge, patients should receive a post-discharge plan for diabetes management, including clear instructions about medications:

    • Name of medication

    • Dosage of medication

    • Dosing schedule

  • All patients should have appropriate follow-up appointments scheduled at time of discharge.

  • Written documentation for primary care physician/healthcare provider should be completed at time of discharge.

Suggested Reading

Clinical Guidelines

American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes Care. 2012;35(suppl 1):S11-63.

Handelsman Y, Mechanick JI, Blonde L, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan. Endocr Pract. 2011;17(suppl 2):1-53.

Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15:353-369.

Rodbard HW, Jellinger PS, Bloomgarden ZT, et al. AACE/ACE diabetes algorithm for glycemic control. December 2009 update.

Rodbard HW, Jellinger PS, Davidson JA, et al. Statement by an American Association of Clinical Endocrinologists/American College of Endocrinology consensus panel on type 2 diabetes mellitus: an algorithm for glycemic control. Endocr Pract. 2009;15:540-559.

Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2012;97:16-38.

Additional Reading

Cook CB, Seifert KM, Hull BP, et al. Inpatient to outpatient transfer of diabetes care: planing for an effective hospital discharge. Endocr Pract. 2009;15:263-269.

Dolovich LR, Nair KM, Ciliska DK, et al. The Diabetes Continuity of Care Scale: the development and initial evaluation of a questionnaire that measures continuity of care from the patient perspective. Health Soc Care Community. 2004;12:475-487.

Dromgoole P. Adjusting diabetes management regimens in response to illness. Prof Nurse. 2005;20:34-36.

Fonseca V. Newly diagnosed diabetes/hyperglycemia in hospitals: what should we do? Endocr Pract. 2006;12(suppl 3):108-111.

Garber AJ, Moghissi ES, Bransome ED Jr, et al. American College of Endocrinology position statement on inpatient diabetes and metabolic control. Endocr Pract. 2004;10:77-82.

Kimmel B, Sullivan MM, Rushakoff RJ. Survey on transition from inpatient to outpatient for patients on insulin: what really goes on at home? Endocr Pract. 2010;16:785-791.

Lavernia F. Treating hyperglycemia and diabetes with insulin therapy: transition from inpatient to outpatient care. Medscape J Med. 2008;10:216.

Lipska KJ, Wang Y, Kosiborod M, et al. Discontinuation of antihyperglycemic therapy and clinical outcomes after acute myocardial infarction in older patients with diabetes. Circ Cardiovasc Qual Outcomes. 2010;3:236-242.

Maniaci MJ, Heckman MG, Dawson NL. Functional health literacy and understanding of medications at discharge. Mayo Clin Proc. 2008;83:554-558.

Peterson G. Transitioning from inpatient to outpatient therapy in patients with in-hospital hyperglycemia. Hosp Pract (Minneap). 2011;39:87-95.

Wheeler K, Crawford R, McAdams D, et al. Inpatient to outpatient transfer of diabetes care: perceptions of barriers to postdischarge followup in urban African American patients. Ethn Dis. 2007;17:238-243.

Wheeler K, Crawford R, McAdams D, et al. Inpatient to outpatient transfer of care in urban patients with diabetes: patterns and determinants of immediate postdischarge follow-up. Arch Intern Med. 2004;164:447-453.