Minneapolis, MN—Are patients who have an abnormal glucose range before hospital discharge at a higher risk of readmission or death over the next 30 days?

A study in the Journal of General Internal Medicine delved into that question.

“Even though clinicians caring for hospitalized patients frequently encounter abnormal glucose values at hospital discharge, and hyperglycemia is associated with worse hospital outcomes, little data exists on the prognostic relevance of the last blood glucose (BG) measurement in the hospital,” note study authors from the University of Minnesota Medical School.

Used in the research was an electronic medical record (EMR)–derived dataset of 126,527 emergent hospital admissions for 67,308 patients within a six-hospital network in the Twin Cities.

The study determined that patients who had an abnormal blood glucose range had a higher rate of hospital readmission and death in the 30 days after hospital discharge. In fact, researchers report, risk increases with the severity of dysglycemia—defined as glucose greater than 100 mg/dL or less than 70 mg/dL—regardless of diagnosis of diabetes mellitus.

Researchers also point to a surprising result. “We also found that patients with ‘borderline’ high glucose levels who did not carry a diagnosis of diabetes had worse outcomes,” said Nishant Sahni, MD, MS, adjunct assistant professor in the Department of Medicine, University of Minnesota Medical School. “This leads us to believe that if you don’t recognize those borderline (diabetic) patients in the hospital, they tend to do worse after hospitalization.”

The study team urged clinicians to improve identification of undiagnosed diabetes and to promote better blood glucose control at hospital discharge and immediately after.

“While we can’t claim causation, the association is very striking,” Sahni emphasized. “I think the next step is having a trial to see if we can intervene and if that reduces the rate. That's going to be the ultimate test to see if this is a problem worth solving.”

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