Hypoglycemia in Patients with Diabetes in an Australian Public Hospital Setting

Autor:	Therese Fletcher, Milan K. Piya, David Simmons, Reetu Zarora
Rok vydání:	2018
Předmět:	medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism Point-of-care testing Audit Hypoglycemia medicine.disease INSULIN USE Diabetes mellitus Public hospital Emergency medicine Internal Medicine Medicine In patient Risk factor business
Zdroj:	Diabetes. 67
ISSN:	1939-327X 0012-1797
DOI:	10.2337/db18-392-p
Popis:	Background: Diabetes is a common co-morbidity among hospital inpatients, particularly in medical wards. Diabetes is linked to increased length of stay and mortality in hospital inpatients, and hypoglycemia (hypo) is considered a contributory factor. We sought to determine the prevalence of diabetes in medical wards and the prevalence and patterns of hypo during their hospital stay. Methods: A daily census on three medical wards (79 beds) was conducted over a 4 month period from June 2017 in a 3bed tertiary Sydney hospital. Charts and medications for inpatients with diabetes were audited each Friday using a questionnaire based on the UK National Diabetes Inpatient Audit. Patients admitted under the care of the diabetes team were excluded. Readmissions were counted as separate episodes. Results: The mean prevalence of diabetes was 27%, of which 2.4% had T1DM, with 212 patient episodes audited in 196 patients (16 readmissions). Mean age (SD) was 71 years (11.2), 54% male. Only 5.6% had a diabetes related admission. Insulin use was 34% on admission but 52% during hospital stay. There were 74 events of hypo ( Conclusion: Hypoglycemia is a major burden in patients with diabetes in hospital, particularly in the first week of admission, even when patients are not admitted due to diabetes related problems. Insulin use was the major risk factor and many patients had multiple hypo events. We recommend early involvement of the diabetes inpatient team as well as centralized point of care testing of glucose to allow early identification of patients at risk. Disclosure M.K. Piya: None. R. Zarora: None. T. Fletcher: None. D. Simmons: Speaker's Bureau; Self; Roche Diabetes Care Health and Digital Solutions, AstraZeneca, Novo Nordisk Inc., Medtronic.
Databáze:	OpenAIRE
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