DIABETES DIGEST – Aug. 22, 2014 – During an emergency hospital admission for an acute illness it is common for patients who are not known to have diabetes to have elevated blood sugar. That factor has been linked to adverse outcomes in those patients. Whether this abnormally high blood sugar level is related to the risk of subsequently developing type 2 diabetes, however, is unknown.
To see if this emergency room hyperglycemia might be an indication of underlying type 2 diabetes, Scottish researchers decided to look at a large number of such patients to see if they could find factors that might predict which emergency room patients admitted to the hospital would go on to later develop type 2 diabetes. The study appears in the Aug. 19, 2014 journal PLOS/Medicine.
After analyzing data from more than 100,000 patients aged 30 years or older who were admitted to a hospital for an acute illness between 2004 and 2008 in Scotland, they found that for people over 40 years old, blood sugar levels measured during an emergency hospital admission can predict the patient’s risk of developing type 2 diabetes.
Using statistical analysis they found that for patients aged 40 years or older, the overall 3-year risk of developing type 2 diabetes was 2.3 percent, however for those with blood sugar levels of 7 mmol/l the risk of developing type 2 was 2.6 percent and when the level was over 11.1 mmol/l the risk increased to 9.9 percent. The same evidence for people under 40 was not strong enough to use for predicting type 2 diabetes.
The study also revealed that emergency room patients with a highly elevated blood glucose level who were admitted to the hospital were one-and-half times more likely to die than those with normal levels.
Among the 86,634 patients who had a blood glucose test taken, there were 2,406 deaths attributed to vascular disease. When they looked at patients with glucose levels from 11.1 mmol/l to greater than 15 mmol/l they found those patients had higher mortality than patients with a glucose of less than 6.1 mmol/l after adjusting for age and sex.
The good news is they developed a risk calculator based on the database and put it online so that clinicians can use it to inform their patients about their long-term risk of type 2 diabetes. According to the researchers their study showed that patients whose blood glucose levels were above 11.1mmol/l on hospital admission for an acute illness should be offered follow-up testing for type 2 diabetes.
An editorial accompanying the study questioned whether the study results can be applied accurately outside of Scotland due to the limited diversity of the study population. Nevertheless, the editor concluded that the risk calculator and a blood sugar level over 11.1 mmol/l in patient over 40 may be useful in helping clinicians to inform their patients about their long-term risk of type 2 diabetes.
No comments:
Post a Comment