Background:
Diabetes Mellitus is a chronic metabolic disease that affects 387 million people
around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with
poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia
is critical to decrease the length of hospital stay and to reduce complications and readmissions.
Objective:
The study aims to examine the prevalence of hyperglycemia and assess the correlates and
management of hyperglycemia in diabetic non-critically ill patients.
Methods:
The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon.
A retrospective chart review was conducted from January 2014 until September 2015. Diabetic
patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out,
followed by a multivariable analysis to study the correlates of hyperglycemia occurrence.
Results:
A total of 235 medical charts were reviewed. Seventy percent of participants suffered from
hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia,
were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the
low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524,
p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia.
The major factor perceived by nurses as a barrier to successful hyperglycemia management was
the lack of knowledge about appropriate insulin use (87.5%).
Conclusion:
Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists;
indicating a compelling need for the development and implementation of protocol-driven insulin
order forms a comprehensive education plan on the appropriate use of insulin.
Limiting intensive care therapy in dying critically Ill patients: Experience from a tertiary care center in United Arab Emirates
