Patients at increased risk for type 2 diabetes after acute care hospitalization complicated by hyperglycemia

Patients without diabetes hospitalized with an acute illness that is complicated by hyperglycemia after admittance may be at increased risk for diabetes and should be monitored for proper diagnosis and treatment, according to new study findings.

In the prospective, observational study, researchers from the University Hospital Centre Rebro, Croatia, hypothesized that acute illness would be associated with an increased risk for type 2 diabetes in the study population. Patients admitted to an ICU between 1998 and 2004 were assigned to either a hyperglycemia group (glucose >7.8 mmol/L; n=193) or a normoglycemia group (n=398).

Blood glucose was measured at least twice-daily, and an oral glucose tolerance test was performed within 6 weeks after hospital discharge; follow-up was 5 years.

Compared with only 3.5% of patients in the normoglycemia group, 17.1% of those with hyperglycemia developed type 2 diabetes during 5 years of follow-up (P<.001).

Further, the overall relative risk for type 2 diabetes in those with hyperglycemia was 5.6 (95% CI, 3.1-10.2); and 2.3 (95% CI, 1.6-3.4) for impaired fasting glucose or impaired glucose tolerance.

According to the researchers, the study was limited to medical ICU patients and should therefore not apply to surgical patients. “A similar study on surgical populations is needed, until then we can only assume a similar effect,” they wrote. “It is possible that surgical patients will need a higher cut-off for hyperglycemia since it is more common.”

Gornik I. Crit Care. 2010;14:R130.