Hospital Hyperglycemia May Predict Future Diabetes

Ivan Gornik worked with a team of researchers from University Hospital Centre Rebro, Croatia, to follow patients for 5 years after they were discharged from the hospital. There were 398 medical ICU patients who were normoglycemic during their hospital stay, of whom 14 (3.5%) developed Type 2 diabetes.

In the hyperglycemia group 193 patients finished follow-up and 33 (17.1%) developed Type 2 diabetes. According to Gornik, "Despite the fact that endocrine and metabolic changes probably occur in all acutely ill patients, evident hyperglycemia is not always present. We hypothesized that hospital acquired hyperglycemia can therefore reveal a patient's predisposition to impaired glucose control, which could in future lead to diabetes."

The research team defined hyperglycemia as glucose 140mg/dL. (≥7.8 mmol/l ) and its incidence in the ICU was similar to that seen in other published work. Gornik said, "Our results suggest that patients with hyperglycemia during acute illness, who are not diagnosed with pre-diabetes or diabetes during or immediately after hospitalization, should be perceived as patients with increased risk of developing diabetes and should as such be regularly monitored and treated appropriately."

A prospective observational study of the relationship of critical illness associated hyperglycemia in medical ICU patients and subsequent development of Type 2 diabetes. Ivan Gornik, Ana Vujaklija-Brajkovic, Ivana Pavlic Renar and Vladimir Gasparovic, Critical Care July 2010