AIMS: People with diabetes who are admitted to hospital are at risk of adverse in-hospital outcomes due to glycaemic dysregulation. Both the prevalence of diabetes and adverse outcomes are higher in rural and regional hospitals where infrastructure is more limited. Digital solutions may facilitate diabetes assessment on admission, so timely care coordination can be provided by inpatient diabetes teams. The aim of this systematic review was to identify and characterise the digital technologies and clinical decision support tools used to triage people with diabetes in the inpatient setting.
METHODS: Six electronic databases were searched for studies published between January 2014 and August 2024 on the use of digital technology or decision support tools to triage adult inpatients with diabetes during a hospital stay. Narrative synthesis was used to report results. The review followed PRISMA guidelines and was registered on PROSPERO (CRD 42021257655).
RESULTS: Nine studies met the inclusion criteria. Three developed or improved systems for referrals to an in-hospital diabetes team. The remaining six reported on efforts to improve information to support referral and included risk prediction for iatrogenic hypoglycaemia, persistent adverse glycaemia and in-hospital mortality among Intensive Care Unit patients with diabetes, and perioperative glycaemic management.
CONCLUSIONS: Digital technologies and clinical decision support tools can improve inpatient triage of people with diabetes. A two-tiered approach consisting of a simple admission risk screen tool followed by dynamic electronic health record surveillance focussed on immediate iatrogenic hypoglycaemia risk for ongoing prioritisation would balance sensitivity at admission with dynamic inpatient risk monitoring.
| Discipline Area | Score |
|---|---|
| Physician |  |
, McMaster University