Endocrine Abstracts

Introduction and objectives: Hyperglycemia is a common problem in hospitalized patients that increases infections, mortality, costs and the hospital stay. The objective of this study is to know the management and control of hyperglycemia in our hospital.

Methods: We designed a cross-sectional observational study. We included patients admitted in the hospital every three days in two months. We excluded patients younger than 15 years, stays less than three days and those of the pediatric, gynecological, emergency and intensive care services. We collected the data from these patients the third day of admission and at discharge. We defined hyperglycemia as two or more capillary glucose values greater than 140 mg/dl.

Results: A total of 328 patients were included. 109 patients had hyperglycemia and 85 were known diabetics. Diabetic patients had the next previous treatments: only oral antidiabetic agents (55.3%), insulin (38.8%), and without treatment (5.9%). During admission 48.5% were treated with insulin sliding scales, 19.2% with insulin bolus-basal regimen, 12.1% with basal insulin, 7.1% with premixed insulin, 2% with only antidiabetic agents and 11.1% without treatment. The glycemic control during admission was considered good in 25% (mean glycemia <140 mg/dl), regular in 45% (140–200 mg/dl) and bad in 29% (>200 mg/dl). Hypoglycemia was diagnosed in 12.5% (2.1% severe). Only 23% patients had a recent HbA1c, with a mean HbA1c of 7.37±1.4%. When the patients discharge from hospital, the antidiabetic treatment for home was not adequately adjusted in 47.4%.

Conclusions: A high percentage of diabetic patients are still treated with insulin sliding scales during hospitalization. Few patients have a good glycemic control. Most of patients hadn’t a recent HbA1c. Finally, treatment is not adequately adjusted at discharge in almost half of patients. That’s why, we believe it’s necessary to create a multidisciplinary protocol to improve the management of the hospital hyperglycemia.