Management of subjects with type 2 diabetes hospitalized in internal medicine units: a cluster-randomized, multicenter study before and after an educational program

Few data are available regarding the adherence to treatment guidelines in individuals with type 2 diabetes mellitus (T2DM) admitted to Internal Medicine Wards (IMW) while no information is available concerning the possible efficacy of an educational intervention aimed at improving adherence in this setting. To explore guidelines adherence and the associated impact on glycemic control in subjects with T2DM hospitalized in IMW before and after an educational intervention, we conducted a 3-phase, cluster-randomized, multicenter study. During Phase 1, we retrospectively collected data from patients with T2DM hospitalized for any cause in IMW for ≥5 days. In Phase 2, an educational training, based on the method of the educational outreach visits (EOV), was developed in 36 out of the 54 centers involved. In Phase 3, conducted 6 months after the training, we replicated the collection of data performed in Phase 1. Overall, we analyzed data from 1909 and 1662 individuals with T2DM during Phase 1 and Phase 3 of the study, respectively. No changes were observed in the difference between mean fasting glycemia levels at discharge vs at admission in Phase 3 comparing EOV vs NO EOV groups. A statistically significant increase in adherence to guidelines was observed from Phase 1 to Phase 3 and a trend toward higher adherence was detected when comparing the EOV and the no EOV groups. A structured educational intervention improves adherence to guidelines for managing T2DM in individuals admitted to IMW but has no effect on short-term glycemic control.

Authors

Institutions

Publication Details

Journal
Internal and Emergency Medicine
Published
2026-03-13
DOI
https://doi.org/10.1007/s11739-025-04238-1
Primary Topic
Diabetes Management and Education
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Management of subjects with type 2 diabetes hospitalized in internal medicine units: a cluster-randomized, multicenter study before and after an educational program

Laura Durola, Sergio Berra, Maurizio Manini, Mauro Maurantonio et al.
Internal and Emergency Medicine
Diabetes Management and Education
article

Management of subjects with type 2 diabetes hospitalized in internal medicine units: a cluster-randomized, multicenter study before and after an educational program

Laura Durola, Sergio Berra, Maurizio Manini, Mauro Maurantonio, ANDREA MONTAGNANI, Alberto Moggi Pignone, Giampietro Beltramello, Teresiano De Franceschi, Francesco Prattichizzo, Massimo Alessandri, Concetta Coronella, Mariangela Barletta, Ernesto De Menis, Tiziana Marcella Attardo, Antonello Ramundo, Ada Zanier, E. Bernero, Martina Lombardi, Elisa Zagarrì, Antonella Leonardi, Francesco D’Angelo, Michela Muriago, Matteo Migazzi, F. Cartabellotta, Gian Paolo Fra, Filomena Pietrantonio, Sabrina Spangaro, Ada Maffettone, Fabrizio Valleggi, F Mastroianni, Cristina Trojani, Nicola Tarquinio, Antonio Greco, Aldo Fierro, Antonino Mazzone, Mauro Scanferlato, Dario Manfellotto, Sabrina Piredda, Giovanni Ferrari, Francesco Ventrella, Mariacarla Ventriglia, Francesco Finizola, Tiziana La Spina, Luigi Magnani, M. Rondana, Giampiero Marino, Mario Pirisi, Tiziana Ciarambino, R. Zoratti, Luconi Maria Paola, Stefano De Carli, S. Cerci, M Laccetti, Anna Sorrentino, Margherita Cirillo, Giorgia Prampolini, Maurizio Tonizzo, Giuseppe Caruso, Giuseppe Campagna, Andrea Fontanella, Davide Lillo, Concetta Mancini, M D’Avino, Raffaella De Giovanni, Maria Serena Fiore, Carmela Gerdano, Maria Ferraro, Gabriella Fantini, Sara Rotunno, Ignazio Maria Morana, Mauro Giordano, Roberta De Angelis, Riccardo Nevola, Paola Novati, Noemi Brendaglia, Angela Pastore, Antonini Raffaella, Matteo Giorgi Pierfranceschi, Margherita Guarini, Raffaella Andreozzi, Fabrizio Santoro, Gabrielli Mariagrazia, Elena Dionigi, FADOI-MINDER Study Group, Javier Rosada, Claudia Castellano, Cirillo Nunzia, Ruggero Pastorelli, Armando Pepe, Maurizio Cavalleri, Alessio Bonaiuto, Daniela Sbocchia, Tommasina Giuliani, Paolo Corradini, Daniela Cottarelli, Adriana Dal Maso, Girola Andrea, Bandini Giulia, Imburgia Mariangela, Micaela Asti, Andrea Giorgi, Clara Pia Pafundi, Larizza Giovanni, Maria Giuseppina Pecora, Luca Perfetti, VogrigNadia Vogrig, Valeria Pellegrini, Maria Antonia Salvia, Petri Roberta, Maria Francesca Bracale, Youssef Saleh, Maurizio Burattini, Antonio Ceriello, Renda Maurizio, Francesco Dentali, Martino Rosamaria, Michele Caselli, Marzia Turilli, Romanello Daniele, Cristina Pizzin, Pietro Gatti, Rebasti Daniela, Cecilia Politi, Chiara Martino, Giancarlo Antonucci, Gabriella Oliva, Giuseppe Miceli, Copat Maria
article en

Abstract

Few data are available regarding the adherence to treatment guidelines in individuals with type 2 diabetes mellitus (T2DM) admitted to Internal Medicine Wards (IMW) while no information is available concerning the possible efficacy of an educational intervention aimed at improving adherence in this setting. To explore guidelines adherence and the associated impact on glycemic control in subjects with T2DM hospitalized in IMW before and after an educational intervention, we conducted a 3-phase, cluster-randomized, multicenter study. During Phase 1, we retrospectively collected data from patients with T2DM hospitalized for any cause in IMW for ≥5 days. In Phase 2, an educational training, based on the method of the educational outreach visits (EOV), was developed in 36 out of the 54 centers involved. In Phase 3, conducted 6 months after the training, we replicated the collection of data performed in Phase 1. Overall, we analyzed data from 1909 and 1662 individuals with T2DM during Phase 1 and Phase 3 of the study, respectively. No changes were observed in the difference between mean fasting glycemia levels at discharge vs at admission in Phase 3 comparing EOV vs NO EOV groups. A statistically significant increase in adherence to guidelines was observed from Phase 1 to Phase 3 and a trend toward higher adherence was detected when comparing the EOV and the no EOV groups. A structured educational intervention improves adherence to guidelines for managing T2DM in individuals admitted to IMW but has no effect on short-term glycemic control.

Internal and Emergency Medicine
University of Foggia (IT), University of Insubria (IT), Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT), University of Campania "Luigi Vanvitelli" (IT), University of Pavia (IT), Casa Sollievo della Sofferenza (IT), Agostino Gemelli University Polyclinic (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ente Ospedaliero Ospedali Galliera (IT), Ospedale Maggiore (IT), Ospedale Antonio Cardarelli (IT), Cereal Research Centre (IT), Azienda Unita' Sanitaria Locale Di Modena (IT), Ospedale regionale di Lugano (CH), ASL Roma (IT), MultiMedica (IT), AULSS 2 Marca Trevigiana (IT), Ospedale San Filippo Neri (IT), San Salvatore Hospital (IT), Santa Maria Nuova Hospital (IT), Azienda Ospedaliera di Cosenza (IT), Ospedale A. Perrino (IT), Nuovo Ospedale San Giovanni di Dio (IT), Ospedale Sant Antonio (IT), Ospedale Garibaldi (IT), Ospedale Civile di Voghera (IT), Ospedale Cervesi di Cattolica (IT), Fondazione FADOI (IT), Azienda Ospedaliera Santa Maria Degli Angeli (IT), Danieli (Italy) (IT), Ospedale Ferdinando Veneziale di Isernia (IT), Azienda Ospedaliero-Universitaria Careggi (IT), Ospedale Santa Maria (IT), Ospedale di Latisana (IT), Getra (Italy) (IT), Fondazione Europea Ricerca Biomedica (IT), Presidio Ospedaliero (IT), Azienda Ospedaliera Sant'Andrea (IT), Ospedale San Bassiano (IT), Ospedale Infermi di Rimini (IT), Fondazione Istituto G. Giglio di Cefalù (IT), Ospedale Sandro Pertini (IT), Ospedale Misericordia - Grosseto (IT), Ospedale Santa Maria Goretti (IT), Ospedale Monaldi (IT), Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Frascati (IT), Ospedale Generale Regionale Francesco Miulli (IT), Ospedale Policlinico San Martino (IT), Ospedale Santa Maria della Misericordia di Rovigo (IT), Ospedale D. Cotugno (IT), Ospedale Buon Consiglio Fatebenefratelli (IT), Gastroenterology Hospital "Saverio de Bellis" (IT), Azienda Usl Toscana Centro (IT), Azienda Sanitaria Locale Roma 3 (IT), Ospedale Civile di Venezia (IT), American Association for the Surgery of Trauma (US), Istituto Nazionale di Riposo e Cura per Anziani (IT), Ospedale Buccheri la Ferla Fatebenefratelli (IT), Azienda Ospedaliera Ospedale Civile di Legnano (IT), Ospedale Santa Corona (IT), Ospedale San Pietro Fatebenefratelli (IT), National Operating Committee on Standards for Athletic Equipment (US)
AstraZeneca, Novo Nordisk
Quality Education
Openalex Percentile: Top 24%
Diabetes Management and Education
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.