Observational study of demographics and glycemia control in inpatients with type 2 diabetes: Challenges and clinical implications

Abstract

Introduction

The objective of the present study was to evaluate the clinical, metabolic control and treatment profiles of patients with type 2 diabetes admitted to a university hospital.

Research design and methods

The study analyzed 5 years of data (2015–2020) in the University Hospital of Lille, France, focusing on stays lasting 48 hours or more for type 2 diabetes patients aged 55 or over. Stays in diabetology, outpatient and day hospital wards were excluded.

Results

Among 2,216,834 stays during the study period, 55,292 (30%) involved diabetic patients. 50,205 (90.2%) concerned wards other than the diabetology department, and 42,865 (85.4%) of these stays involved patients with type 2 diabetes. Median [interquartile range] age was 70 years [range, 64, 79], median glycated hemoglobin level 6.8% [range, 6.1, 7.8], and median hospital stay 8 days [range, 4.3, 15.1]. A total of 55.3% of the patients treated with insulin, 40.5% with oral antidiabetic drugs, 12.5% a combination of the two, and 16.5% with lifestyle and dietary measures alone. Only 13,640 (31.8%) stays had data for glycated hemoglobin, and a third of these revealed chronic metabolic imbalance. Data on glycated hemoglobin were available for only 43.5% by patients on insulin, 51.1% for patients taking 3 oral antidiabetic drugs, and 54.9% for patients taking 4 oral antidiabetic drugs.

Conclusion

It is necessary to optimize the management of people with diabetes admitted outside diabetes wards, ensuring at least HbA1c evaluation. Despite the use of various therapies, including hypoglycemic agents, few patients receive appropriate metabolic balance assessments with HbA1c as gold-standard. Optimizing collaboration between clinicians and use of clinical decision support system alerts can help in at-risk situations.