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Abstract
Aims: To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China.
Methods: A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included. Aspects of glycemic management examined were (a) hyperglycemia, (b) endocrinology consultation for hyperglycemia and (c) hypoglycemia.
Results: The prevalence of hyperglycemia in internal medicine was 45.7% (886 out of 1939). A total of 741 (83.6%) patients were treated by non-endocrinology departments; of those, 230 (31.1%) were in poor glycemic control and needed an endocrinology consultation. Yet only 57 (24.8%) received one. In 4 cases, the physician did not follow the consultants’ advice. Among the remaining 53 consulted patients, 35 (66.1%) were still in poor glycemic control, yet only about half received a second consultation. Finally, among patients treated in non-endocrinology departments, 58 (7.8%) had hypoglycemia; less than half retested their blood glucose after treatment.
Conclusions: The majority of patients with hyperglycemia were in non-endocrinology departments. Their glycemic management was poor; the endocrinology consultation rate was low and the result was suboptimal. Also, the management of hypoglycemia was not ideal. Therefore, improving glycemic management is urgently needed in Chinese hospitals.
Transparency
Declaration of funding
No funding was received.
Author contributions: S.H., N.Z., A.F. and Q.L. contributed to drafting and revising the manuscript critically for important intellectual content. X.Y., L.L. and F.L. supervised data collection and management. Z.F. and Q.L. oversaw data quality and revised the manuscript as needed. All authors gave approval of the final version, and agree to be accountable for all aspects of the work.
Declaration of financial/other relationships
S.H., N.Z., A.F.F., X.Y., L.L., F.L., Z.F. and Q.L. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.
CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Acknowledgements
The authors sincerely thank all the investigators and their staff for participation in this study.