Medical Education to Improve Diabetes Care and Outcomes in Hospitalized Patients

Not Applicable

Completed

• Conditions: Diabete Type 2; Hyperglycemic Therapy; Medical Education; Telemedecine

• Registration Number: NCT07108426
• Lead Sponsor: Catholic University of Pelotas

Brief Summary

This clinical trial aims to evaluate whether a structured medical education strategy can improve the quality of care provided to hospitalized patients with diabetes or hyperglycemia. Internal medicine residents from four university hospitals in southern Brazil are assigned to two groups: an intervention group receiving a 30-minute online lecture and 30 days of educational follow-up via WhatsApp®, and a control group receiving no additional training.

The primary goal is to assess changes in physicians' knowledge about inpatient glycemic control. Secondary goals include evaluating the quality of insulin prescriptions, rates of hyperglycemia and hypoglycemia, and hospital length of stay.

Detailed Description

Hospital hyperglycemia is associated with increased morbidity, length of stay, and hospital costs, especially when not properly managed. Many internal medicine teams lack adequate training on glycemic control in hospitalized patients, and guidelines are not consistently followed in clinical practice.

This multicenter, randomized, open-label trial is designed to evaluate whether a telemedicine-based educational intervention can improve medical knowledge and clinical management of inpatient hyperglycemia. Internal medicine residents from four university hospitals in southern Brazil are randomized by clinical team into two groups: one receives a 30-minute online class and continued support via WhatsApp® for 30 days; the control group receives no intervention.

Medical knowledge is assessed using a validated questionnaire before and after the intervention. Secondary outcomes include the appropriateness of glycemic monitoring and insulin prescriptions, frequency of hyper- and hypoglycemia and hospital length of stay.

Study Timeline

• Study Start: 2024-08-01
• Primary Completion: 2025-05-31
• Study Completion: 2025-05-31
• Study First Submitted: 2025-07-19
• Status Verified: 2025-08
• Study First Submitted QC: 2025-08-04
• Last Update Submitted: 2025-08-04
• Study First Posted: 2025-08-07
• Last Update Posted: 2025-08-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• Internal medicine residents from clinical teams at the participating university hospitals in southern Brazil.
• Residents assigned to clinical teams during the intervention month.
• Provided informed consent to participate in the study.

Exclusion Criteria

• Residents on vacation during the intervention month.
• Residents from teams supervised by endocrinologists.
• Refusal to participate in the study.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Improvement in medical knowledge regarding inpatient hyperglycemia	Baseline and 30 days post-intervention	Medical knowledge will be assessed using a structured and validated questionnaire on hospital hyperglycemia and diabetes, administered before and 30 days after the intervention. The questionnaire includes multiple-choice clinical case scenarios related to glycemic monitoring, insulin use, treatment errors, and glycemic targets.

Secondary Outcome Measures

Name	Time	Method
Occurrence of hyperglycemia	Last 5 days of hospitalization during the 30-day intervention period	Percentage of capillary glucose (CG) readings \>180 mg/dL during the last 5 days of hospitalization.
Quality of insulin prescription	Last 5 days of hospitalization during the 30-day intervention period	Proportion of prescriptions that include appropriate insulin regimens (e.g., basal or basal-bolus) versus sliding-scale insulin alone.
Time in glycemic target range	Last 5 days of hospitalization during the 30-day intervention period	Percentage of CG readings within the 70-180 mg/dL range during the last 5 days of hospitalization.
Occurrence of hypoglycemia	Last 5 days of hospitalization during the 30-day intervention period	Percentage of CG readings \<70 mg/dL during the last 5 days of hospitalization.
Glycated hemoglobin ordered at hospital admission	During the 30-day intervention period	Proportion of patients for whom glycated hemoglobin (HbA1c) was ordered at admission.
Length of hospital stay	During the 30-day intervention period	Duration in days from hospital admission to discharge.

Trial Locations

Locations (1)

Catholic University of Pelotas; 🇧🇷 Pelotas, RS, Brazil