Abstract
Background One in five hospitalized patients presents with previously undetected diabetes mellitus
(DM). We assessed whether hospital doctors measure HbA1c in hospitalized patients and act consequently.
Methods Data from patients hospitalized between January 2013 and December 2014 in a Swiss
teaching hospital was collected. We assessed the frequency of HbA1c measurements and
the number of newly detected prediabetes or DM. We also examined whether HbA1c values
were associated with the antidiabetic drugs prescription and reporting of DM in the
discharge letter.
Results Of the 2618 patients studied, 298 (11.4%) had HbA1c measured, of whom 136 (45.6%) had no previous history of DM. Of the 136 patients
without history of DM, 51 (37.5%) had prediabetic state and 23 (16.9%) had DM. Newly
detected prediabetes or DM were reported in 5.8% (3/51) and 65.8% of cases (15/23),
respectively. Only half of patients (11/23, 47.8%) with newly detected DM received
antidiabetic drug treatment at discharge. Patients with newly detected DM (n=23) had
a longer length of stay (median and interquartile range: 16 [9–25] versus 10 [8–16]
days, p=0.028) compared to patients without DM, while no such differences were found
regarding in-hospital mortality.
Conclusions Hospital doctors seldom prescribe HbA1c measurement in medical hospitalized patients.
Prescription of HbA1c measurement leads to a high detection rate (53%) of (pre)DM among patients unaware
of their status, but management and reporting of these conditions at discharge could
be further improved.
Key words
diabetes mellitus - pre-diabetes - HbA1c measurement - in-hospital screening
