Prevalence of Hemoglobin A1c Greater Than 6.5% and 7.0% among Hospitalized Patients without Known Diagnosis of Diabetes at an Urban Inner City Hospital

Mazurek, Jeremy A.; Hailpern, Susan M.; Goring, Tabitha N.; Nordin, Charles

doi:10.1210/jc.2009-1151

Cited by 48 publications

(30 citation statements)

References 14 publications

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“…28 Measurement of HbA1c in patients with hyperglycemia during hospitalization provides the opportunity to differentiate patients with stress hyperglycemia from those with diabetes who were previously undiagnosed. 29 The Endocrine Society guidelines indicate that patients with hyperglycemia and HbA1C of 6.5% or higher can be identified as having diabetes. 30 …”

Section: Introductionmentioning

confidence: 99%

Perioperative Hyperglycemia Management

2017

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Section: Introductionmentioning

confidence: 99%

Perioperative Hyperglycemia Management

2017

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“…[2] More recently, the use of glycated hemoglobin (HbA1c) has been recommended over oral glucose tolerance test as the preferred diagnostic testing in hospitalized patients with hyperglycemia. [3] Measurement of an HbA1c during periods of hospitalization provides the opportunity to differentiate patients with stress hyperglycemia from those with diabetes who were previously undiagnosed. [4]…”

Section: Introductionmentioning

confidence: 99%

Clinical and epidemiological study of stress hyperglycemia among medical intensive care unit patients in Central India

Sharma

Chittawar

Maniram

et al. 2017

Indian J Endocr Metab

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Background:Stress hyperglycemia is common in patients presenting at the emergency medical ward and is associated with poor prognosis and increased risk of mortality.Aims and Objective:To study and determine the prevalence and factors associated with stress hyperglycemia.Materials and Methods:A cross-sectional observational study was performed on 536 nondiabetic patients presented to the Intensive Care Unit (ICU) at Gandhi Medical College and allied Hamidia Hospital, Bhopal, between March 31, 2015, and May 28, 2015. A detailed history including demographic profile, presence of chronic disease, history of hospitalization and ICU admission, surgical status, and major reason for ICU admission (i.e., predominant diagnostic category) was collected. Hematological and other parameters based on profile of study population were also analyzed.Results:Out of 536 patients, 109 (20.33%) had stress hyperglycemia. Out of 109 patients with stress hyperglycemia, 87 (16.23%) patients had glycated hemoglobin (HbA1c) <5.7% and 22 (4.10%) patients had HbA1c between 5.7% and 6.4%. Mean age of the study population was 40.27 ± 1.44 years, with male dominance. Mean random blood glucose level was 181.46 ± 3.80 mg/dl. Frequency of stress hyperglycemia was 24.13% in stroke, 19.54% in multiple organ dysfunction syndrome (MODS), 17.24% in chronic kidney disease (CKD), 12.64% in central nervous system (CNS) infection, 8.05% in chronic liver disease (CLD), and 8.05% in seizure patients. Association between stroke and stress hyperglycemia was significant (P = 0.036). Association between hospital stay more than 7 days and stress hyperglycemia was significant in stroke patients (P = 0.0029), CKD patients (P = 0.0036), CLD (P = 0.0099), and MODS patients (P = 0.0328).Conclusions:The factors associated with stress hyperglycemia were stroke, MODS, CKD, CNS infection, CLD, seizure patients, with prolonged hospital stay and expected proportion.

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“…An estimated 25% of hospitalized patients carry the diagnosis of diabetes, and potentially up to another 18% to 25% of patients have undiagnosed type 2 diabetes [15, 16•, 17]. The RABBIT 2 (Randomized Study of Basal-Bolus Insulin Therapy in the Inpatient Management of Patients with Type 2 Diabetes) trial, published in 2007, and its surgical counterpart, published in 2011, have demonstrated the benefits of basal-bolus insulin compared with sliding scale alone for glycemic control in general medicine and surgical type 2 diabetes patients, respectively.…”

Section: Introductionmentioning

confidence: 99%

Basal-Bolus Insulin Protocols Enter the Computer Age

Wei

Wexler

2011

Curr Diab Rep

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Diabetes affects approximately one quarter of all hospitalized patients. Poor inpatient glycemic control has been associated with increased risk for multiple adverse events including surgical site infections, prolonged hospital length of stay, and mortality. Inpatient glycemic control protocols based on physiologic basal-bolus insulin regimens have been shown to improve glycemia and clinical outcomes and are recommended by the American Diabetes Association, the American Association of Clinical Endocrinologists, and the Society of Hospital Medicine for inpatient glycemic management of noncritically ill patients. The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act will catalyze widespread computerized medication order entry implementation over the next few years. Here, we focus on the noncritical care setting and review the background on inpatient glycemic management as it pertains to computerized order entry, the translation and efficacy of computerizing glycemic control protocols, and the barriers to computerizing glycemic protocols.

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Prevalence of Hemoglobin A1c Greater Than 6.5% and 7.0% among Hospitalized Patients without Known Diagnosis of Diabetes at an Urban Inner City Hospital

Cited by 48 publications

References 14 publications

Perioperative Hyperglycemia Management

Perioperative Hyperglycemia Management

Clinical and epidemiological study of stress hyperglycemia among medical intensive care unit patients in Central India

Basal-Bolus Insulin Protocols Enter the Computer Age

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