New-Onset Type 2 Diabetes Mellitus in Critical Illness Survivors and after Hospitalization

Recent literature suggests that hospitalization may lead to new-onset type 2 diabetes mellitus (NODM2). Understanding this relationship is crucial for developing interventions that could reduce long-term complications and healthcare costs associated with DM2 and major adverse cardiovascular events (MACE). This systematic review and meta-analysis aims to assess the incidence of NODM2 and MACE in patients after hospitalization.

With the assistance of the Mayo Clinic Libraries, we searched MEDLINE, Cochrane, and Scopus for medical literature reporting the incidence of NODM2 and the presence of MACE in hospitalized patients from database inception to March 2024. The systematic review and meta-analysis were performed according to the guidelines of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines.

Among the 168,673 patients from 25 studies, 7677 developed NODM2 after hospitalization (4.5%). The pooled incidence rate was 9.8% (95% confidence interval 5.5%-14.1%, P < 0.001). An exploratory analysis comparing patients' glycemic statuses showed a significantly increased risk of NODM2 development after hospitalization among patients with impaired glucose tolerance or stress hyperglycemia compared to normoglycemia group. Only one eligible study reported any MACE outcomes, and meta-analysis could not be performed to assess the effects of hospitalization on MACE.

This study highlights the high rate of NODM2 development after hospitalization. Growing evidence suggests that it may lead to long-term metabolic complications, particularly in patients who experienced dysglycemia during illness.