Beyond Hospital Readmissions: A Multifaceted Insulin-Centered Diabetes Education Approach Impacts Contemporary Acute Care Outcomes and Prolongs Home Time
Authors' conclusion
A multifaceted approach targeting insulin use through individualized ISAST education, initiated inpatient and continued at home through phone visits, significantly reduced 30-day all-cause and diabetes-related ACV, including ER-V, H-OBS and inpatient returns, while increasing non-ACV home time, when compared to inpatient-only ISAST education and PD-UC.
Study context
- Population
- Adults with diabetes leaving a teaching hospital on insulin, 2017–2024
- Participants
- 1,217 adults
- Comparison
- Post-discharge insulin-centered transition of care (TOC) vs post-discharge usual care
- PD-ITOCn = 970
- PD-UCn = 247reference
- Outcome
- All-cause and diabetes-related acute care visits (ACVs), incl. inpatient returns, hospital observation (H-OBS) and ER visits (emergency room visits (ER-Vs))
- Follow-up
- 30 days
Methodological detailspropensity score weighting
- Propensity score weighting
Main finding
As reported in the abstract
Hospital returns, incl. H-OBS
PD-ITOC vs PD-UCOdds ratio (95% CI)
All-cause
0.37(0.25–0.55)
Diabetes-related
0.30(0.14–0.66)
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| ER visits · 30 daysPD-ITOCvs PD-UCAll-cause | 0.53 (0.36–0.77) | |
| ER visits · 30 daysPD-ITOCvs PD-UCDiabetes-related | 0.50 (0.25–0.99) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | P value |
|---|---|
| Non-ACV home timeLonger with PD-ITOC | P < 0.0001 |
Original publication
Beyond Hospital Readmissions: A Multifaceted Insulin-Centered Diabetes Education Approach Impacts Contemporary Acute Care Outcomes and Prolongs Home Time. Endocr Pract. Published 3 June 2026. doi:10.
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