Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2016

Diabetes in hospitalised patients; a whole of hospital single day evaluation. (#287)

Catherine Li 1 , Kerry Fitzsimons 2 , Pixie Barrie 3 , Gerry Fegan 3
  1. Safety, Quality & Risk , Fiona Stanley Hospital, Perth, Western Australia, Australia
  2. Pharmacy, Fiona Stanley Hospital, Perth, West Australia, Australia
  3. Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, West Australia, Australia
Background: Patients with diabetes are often admitted to hospital, usually related to conditions other than their diabetes. Inpatient glycaemic control is associated with health outcomes. Aims: To determine 1) the prevalence of diabetes and 2) the levels of glycaemia in hospital patients. Setting: Fiona Stanley Hospital; a quaternary hospital in West Australia. Methods: 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. Results: 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). Conclusion: 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.