Patients with diabetes are often admitted to hospital, usually related to conditions other than their diabetes. Inpatient glycaemic control is associated with health outcomes.
To determine 1) the prevalence of diabetes and 2) the levels of glycaemia in hospital patients.
Fiona Stanley Hospital; a quaternary hospital in West Australia.
A point prevalence survey of hospital patients was undertaken on a single day in November 2015. All adult in-patients were included, except < 16 years or on obstetric or intensive care units. Patients were identified as having a diagnosis of diabetes mellitus by each nurse unit manager. An audit tool was then completed for each identified patient.
Ninety two in-patients were identified with diabetes on the day. The total number of inpatients on the day was 441. In-patient diabetes prevalence was 21.5%.
Of the 92 patients audited, 83 (90%) had type 2 diabetes, 3 (3%) had type 1 diabetes and remainder unknown. 46% of patients were prescribed subcutaneous insulin and 51% of these were on 4 or more insulin injections per day.
Bedside glucose levels (BGLs) were reviewed retrospectively for up to maximum of 7 days per patient. Total number of BGLs reviewed was 1479. Number of BGL <4mmol/L was 38 (3% of all BGLs reviewed). Number of BGL <2.8mmol/L was 3 (0.2% of BGLs reviewed). Number of BGL 4-12mmol/L was 1051 (71% of BGLs reviewed). Number of BGL >12mmol/L was 378 (26% of BGLs reviewed). Number of BGL >16mmol/L was 139 (9% of BGLs reviewed). Approximately a third (32.6%) of patients had HbA1c performed. Mean HBA1c was 8.6% (+/-2.7SD).
Approximately one fifth if in-patients had diabetes. Approximately three quarters of blood sugar levels within recommended levels yet hyperglycaemia is still common. Severe hypoglycaemia appears rare.