Prevalence and Factors Associated with Hyperglycaemia Among Newly Admitted Medical Patients at a Tertiary Hospital in...

Hyperglycaemia is common during acute illness and may occur in individuals with previously known diabetes, previously undiagnosed diabetes, or stress‑related hyperglycaemia. In hospital settings, definitions vary across studies, and data on admission hyperglycaemia among adult medical emergency patients in Uganda remain limited. This study aimed to determine the prevalence of hyperglycaemia and identify factors associated with it among newly admitted adult medical patients at Mbale Regional Referral Hospital (MRRH).

We conducted a prospective cross-sectional study among newly admitted adult medical patients at the emergency ward of Mbale Regional Referral Hospital in eastern Uganda. Socio‑demographic, clinical, and laboratory data were collected using a pretested structured tool. Hyperglycaemia was defined as a random capillary blood glucose of at least 7.8 mmol/L at admission. Glycated haemoglobin (HbA1c) was used to classify participants with hyperglycaemia as having probable previously undiagnosed diabetes mellitus if HbA1c was ≥6.5%, or stress hyperglycaemia if HbA1c was ≤6.4%. Modified Poisson regression was used to estimate adjusted prevalence ratios with 95% confidence intervals.

A total of 449 participants were enrolled, of whom 51.2% were female. The prevalence of hyperglycaemia at admission was 42.8%, while 14.5% of the total study population were classified as having previously undiagnosed diabetes based on admission glucose and HbA1c. Among participants with hyperglycaemia, 27.6% had known diabetes, 38.5% were classified as having stress hyperglycaemia, and 33.9% were classified as having previously undiagnosed diabetes. Factors associated with hyperglycaemia were prior diagnosis of diabetes mellitus [aPR 1.9, 95% CI: 1.7-2.4, p<0.001], Modified Early Warning Signs (MEWS) scores ≥5 [aPR 1.5, 95% CI: 1.2-1.9, p=0.002] and Tertiary level of education [aPR 1.6, 95% CI: 1.1-2.3, p=0.019].

This study found a high point prevalence of admission hyperglycaemia among newly admitted adult medical patients, including a substantial proportion classified as having probable previously undiagnosed diabetes mellitus. Hyperglycaemia was independently associated with tertiary education, prior diabetes diagnosis, and higher illness severity. These findings suggest that admission glucose assessment may be useful for identifying undetected hyperglycaemia, supporting emergency triage, and guiding post‑discharge metabolic follow‑up among acutely ill medical patients. Because this was a single‑site cross‑sectional study, further prospective studies are needed to validate these findings, examine patient outcomes, and clarify how admission glucose assessment may inform inpatient monitoring and follow‑up pathways.