Hospital Hyperglycemia is Associated with Adverse Short-term Metabolic and Mortality Outcomes

Stress hyperglycemia has been implicated in acute illnesses, but the risk of future diabetes is seldom studied. Hospital hyperglycemia, as defined by in-hospital random blood glucose (RBG) >140 mg/dL, is much less studied. This study aimed to determine the profile and short-term outcome of hospital hyperglycemia patients.

A descriptive follow-up study was conducted in 50 patients with hospital hyperglycemia. Based on their HbA1c status, patients were categorized into known cases of diabetes (group A, n = 12, 24%), undiagnosed diabetes (group B, n = 13, 26%), prediabetes (group C, n = 13, 26%), and normoglycemic (group D, n = 12, 24%). Duration of hospital stay and in-hospital mortality were noted. At 4 weeks post-discharge, HbA1c, along with the glucose tolerance test, was performed for groups C and D, and outcomes were recorded.

Half of the hospital hyperglycemia patients were diabetic, although 26% of the patients with hospital hyperglycemia were unaware of their diabetes status. Average age and BMI were found to be higher in diabetes patients (25.63 ± 5.25 kg/m²) than prediabetes (22.98 ± 2.24 kg/m²) and normoglycemic patients (21.38 ± 2.37 kg/m²). Two deaths were encountered during hospital stay in the prediabetes group. At 4 weeks post-discharge, in group C, 2 (8.7%) developed diabetes, 4 (17.4%) had impaired fasting glucose, and 3 (13%) had impaired glucose tolerance. One prediabetes patient became normoglycemic. All 12 patients of group D remained normoglycemic.

Hospital hyperglycemia in diabetics as well as prediabetes subjects is associated with a higher age and BMI compared to normoglycemic individuals. Hospital hyperglycemia in prediabetes subjects is associated with higher mortality and greater propensity to develop diabetes in the short-term, compared to normoglycemic individuals.