Monday, December 08, 2008

Screening During Hospital Admission An Opportunity To Identify Unrecognized Diabetes

Dr. Deborah Wexler and her colleagues at Massachusetts General Hospital in Boston screened 695 adult patients admitted during 11 days in 2006.

How many of those had an HbA1c greater than 6.1% (indicating probable diabetes) but had no diagnosis?
"Nearly one in five adult patients admitted to a large general hospital had unrecognized probable diabetes, based on elevated HbA1c levels."
That rate, the authors said, was "roughly 5-fold higher than in the general outpatient population."

Also, random blood sugar tests performed during the patients' hospital stay were found to be poorly predictive of diabetes. In this case, sampling blood glucose with a meter was not as effective as assessing blood glucose over the prior few months, which an HbA1c test can measure.

Unfortunately, only 15% of those with elevated HbA1c were diagnosed within a year, pointing to a area where more attentive follow-up could prevent diabetes-related complications.

Dr. Wexler's research was published in the November issue of the Journal of Clinical Endocrinology & Metabolism:
Prevalence Of Elevated Hemoglobin A1c Among Patients Admitted To The Hospital Without A Diagnosis Of Diabetes