SHS is part of a multicenter study on managing diabetes patients when they are hospitalized for acute illness.

"During hospitalization, diabetes can be difficult to manage, and often physicians and other caregivers are faced with complex care decisions about how to manage chronic diabetes while dealing with the acute illness that triggered thehospitalization," explained the physician liaison for the study, endocrinologist Fredric B. Kraemer, associate professor of medicine.

Between April and November, Beverly Dyck, clinical nurse coordinator, and colleagues will identify approximately 180 patients at the time of their hospitalization as possible study participants. Criteria to join the study includes a secondary diagnosis of diabetes and one of three primary diagnoses: acute myocardial infarction, coronary artery bypass graft or pneumonia.

The nationwide study of approximately 1,800 patients is sponsored by the 40-member University HealthSystem Consortium (UHC) at its institutions and will be coordinated by UHC's Clinical Process Improvement Program.

Data collected from patients identified by the Stanford team will be forwarded to the UHC, which will send a survey about four weeks after hospitalization. Patients who mail back the survey will be enrolled in the study and will be sent a second survey about six months after hospitalization. Retrospective hospital data will be collected on participants.

Dyck said all data will be reported in the aggregate. The study will be analyzed for process variation among institutions, opportunities for improvement in the hospital management of diabetes as a secondary condition, and related health outcomes.

Patient surveys will include the Medical Outcomes Trust version of the SF 36, three depression questions, specific questions on diabetes management, as well as questions relating to patient expectation and satisfaction. Patients will also be asked questions about comorbidities, demographic information and health-risk behaviors.

"If patients ask their physicians about the survey, we do hope that you'll encourage them to participate so that we will all be able to serve a complex group of patients more effectively," Kraemer said. "Diabetes mellitus is, after all, the sixth leading cause of death in the United States and, therefore, is an important target for health management efforts."

For further information, contact Kraemer at (415) 723-6054 or Dyck at (415) 725-2609.