Prevalência da diabetes mellitus no internamento de um hospital central

Abstract

BackgroundDiabetes mellitus (DM) is a growing condition, although frequently underestimated in the hospital setting. AimTo determine the prevalence of DM in a general hospital, as well as the glycemic profile of patients with diabetes according to main diagnosis and length‐of‐stay (LOS). Material and methodsA cross‐sectional analysis was performed in adult wards of CHP except Obstetrics’ on the 13th December 2011. Patients with diabetes were defined by the previous history or clinical registry of DM and; those with 2 or more venous glycemia ≥200mg/dl were also assumed to have DM. Glycemic control was estimated by capillary glycemia in the day before evaluation 2 and categorized in hypoglycemia (<70mg/dl), normoglycemia (70‐179mg/dl) or hyperglycemia (≥180mg/dl). Main diagnosis was categorized in infection/non‐infection and the duration of hospitalization until the study day in groups A:1‐3 days, B:4‐7 days, C:8‐14 days, D:15‐30 days or E:more than 30 days. Results523 patients were analysed, 145 were diabetic (27.7%), mostly type 2. Only 21.9% had normoglycaemic control and most of them were under sliding scale treatment. Comparison between groups showed that mean minimal glycemia was significantly different between them (highest in group B and decreasing from B to E, p=0.002). Group E had higher insulin treatment rate than group B (57.1% vs 19.4%, p=0.02). Patients at the “infection” group were less frequently under basal insulin regimen than the non‐infection one (p=0.01). Discussion and conclusionDespite the high prevalence of diabetes among hospitalized patients, only a minority seemed to be normoglycemic. The worst metabolic control and lowest insulin treatment rate was seen at the end of first week and in those patients at the “infection” category. The authors emphasize the relevance to achieve good inpatient metabolic control, especially in infected subjects.