Diabete Type 2, Hyperglycemic Therapy, Medical Education, Telemedecine
Conditions
Keywords
diabetes mellitus, telemedicine, medical education, hospital hyperglycemia, insulin therapy
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.
Interventions
BEHAVIORALEducational Intervention via Telemedicine
A structured educational program delivered remotely through WhatsApp®, including a 30-minute online lecture and daily dissemination of educational content (videos, texts, and practical guidance) on hospital hyperglycemia and glycemic management strategies.
Sponsors
Federal University of Health Science of Porto Alegre
Universidade Federal do Rio Grande (FURG)
Federal University of Pelotas
Catholic University of Pelotas
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
This is a multicenter, open-label, parallel-group randomized clinical trial designed to assess the impact of a structured medical education program on physicians' knowledge and hospital outcomes in patients with diabetes. Internal medicine resident teams from four Brazilian university hospitals were randomized to either an intervention group, which received a virtual class and 30-day follow-up via WhatsApp®, or a control group with usual practice. Outcomes include improvement in medical knowledge, quality of diabetes-related prescriptions, glycemic control, hospital length of stay, and readmission rates.
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
Countries
Brazil
Outcome results
None listed