PDB47 - Trend in HBA1C Levels Among Primary Care Diabetes Patients Admitted to a Tertiary Hospital in Singapore in 2013

Abstract

Hospital admissions have been proposed as an opportunity to improve glycaemic control of patients with poorly controlled diabetes mellitus due to the intense daily exposure to clinical care teams and opportunities for medication titration. This study examined the historical trends in glycated hemoglobin (HbA1c) levels of diabetes patients admitted in medical and surgical disciplines to serve as baseline for comparison for proposed interventions to improve glycaemic control of diabetes patients during admissions. This is a retrospective cohort study of all diabetes patients seen at 9 primary care clinics admitted to a tertiary hospital in Singapore in 2013. We extracted HbA1c levels at baseline, 6 months and 12 months after discharge. We identified 2,682 diabetes patients from our chronic disease registry. 1,759 (65.6%) were admitted into medical disciplines while the rest were admitted into surgical disciplines. The medical patients were older (mean age 71.1 years old) compared to surgical patients (mean age 70.0 years old) and had higher baseline HbA1c levels (7.61% vs 7.39%) but comparable in terms of gender and ethnicity. There was a significant difference in HbA1c levels for medical patients 6 months (7.40%), 12 months (7.44%) after discharge compared to baseline (7.61%). For surgical patients, the difference was statistically significant for 6 months (7.16%) but not 12 months (7.34%) after discharge when compared to baseline (7.39%). Glycaemic control is better in both medical and surgical patients 6 months after discharge but only better in medical patients 12 months after discharge. More research is needed to explore the use of hospital admissions to improve glycaemic control especially in the long term.