Background
Diabetes in hospitalised patients is associated with poorer clinical outcomes and longer length of stay. The prevalence of in-patient diabetes at Fiona Stanley Hospital soon after opening was 21.5%.
Aims
Determine current prevalence of in-patient diabetes and glycaemic control in two public hospitals. Compare this information with previous year’s data.
Setting
Fiona Stanley Hospital (FSH), a quaternary hospital and Fremantle Hospital (FH), a specialist hospital.
Methods
A single day, point-prevalence survey of inpatients was performed at FSH and FH in November 2016. All adult in-patients were included, except patients in obstetric, intensive care or mental health units. Patients with diabetes were identified from ward nurse unit manager, clinical handover document and medical record. An audit tool was completed for each patient. Blood glucose levels (BGLs) were retrospectively reviewed up to seven days.
Findings
140 (20.1%) in-patients with diabetes were identified (FSH 20.2%; FH 20.0%) compared with 92 (21.5%) in 2015 (FSH only). Type 2 diabetes in all except 3% with T1DM. Median length of stay was 8 days (FSH 6 days, FH 13 days).
Total of 1997 BGLs were collected. 74.2% were 4-12mmol/L. 1.6% were <4.0mmol/L. 0.5% were <2.0mmol/L. 24.2% were >12mmol/L. 10.3% were >16mmol/L which occurred in 25% of patients. These categories are similar to 2015. HbA1c recorded in 51.7% of patients (32.6% in 2015). Mean HbA1c 7.51% vs 8.6% in 2015.
45% of in-patients were prescribed subcutaneous insulin. 22.2% were receiving ≥4 insulin injections per day.
Conclusion
1 in 5 hospital beds have someone with diabetes in them. The prevalence of inpatient diabetes and glycaemic control was similar to previous review. Whilst hypoglycaemia was infrequent, hyperglycaemia was common, affecting half of inpatients. HbA1c recording is suboptimal but improving. This data will allow hospital wide diabetes care planning.