A Comparison of a Consistent Carbohydrate Diet with a Patient Controlled Diet in Hospitalized Patients with Diabetes
Abstract Number: 1653-P
Authors: MICHELLE M. CURLL, MONICA DINARDO, KRISTINE RUPPERT, MICHELLE NOCHESE, TRACY BANKS, MARY KORYTKOWSKI.
Institutions: Pittsburgh, PA.
Results: Diabetes is listed as an underlying diagnosis in 12 to 25% of all admissions, yet, dietary management has not been well studied in the inpatient setting. To address this, a quality improvement project was implemented to compare a structured consistent carbohydrate diet (CCD) with a liberalized patient controlled diet (PCD). The CCD is a standard hospital meal plan, that guides the choice of a consistent amount of carbohydrate at each meal with automatic edits of inappropriate selections. The PCD allows wider menu selections with monitoring and educational intervention provided by nutrition staff for repeated inappropriate menu selections. 52 consecutive patients on three cardiac units for whom a diabetes meal plan was ordered and who received the CCD (n=23) or PCD (n=29) according to location were included. All patients were followed for % correct menu choices, glycemic control, nutritionist time for patient education and satisfaction with nutrition services. The frequency of inappropriate meal choices was similar in both groups (CCD vs PCD 37% vs 31%). Approximately one half (14/29) of the PCD group required a nutrition education visit due to consistent menu errors. In 8 patients with available dietary data before and following the education visit, there was a decrease in menu errors (47% to 27%, p = 0.09).
Episodes of Abnormal Blood Glucose Levels in CCD vs. PCD*episodes/100 patient daysIn summary, the CCD group experienced better BG control in the hospital while those in the PCD received more dietary education and reported greater satisfaction with the hospital diet. Hospitals need to consider the benefits and opportunities of each diet plan in determining which may best meet their patients' needs.