Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity
Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity
Aims: to establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement.
Methods: electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance.
Results: three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P < .001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were ‘at risk’ (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P < .001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours.
Conclusions: hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions.
emergency admissions, hyperglycaemia, undiagnosed diabetes
Ghosh, Sandip
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Manley, Susan E.
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Nightingale, Peter G.
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Williams, John A.
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Susarla, Radhika
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Alonso-Perez, Irene
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Stratton, Irene M.
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Gkoutos, Georgios V.
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Webber, Jonathan
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Luzio, Stephen D.
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Hanif, Wasim
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Roberts, Graham A.
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15 May 2020
Ghosh, Sandip
04ee9d4d-56a5-4103-a264-9d613c3ade14
Manley, Susan E.
46bacfff-cf40-4894-86d8-4aa07e302e70
Nightingale, Peter G.
643f789b-872d-4d35-8b85-89cf26ac3020
Williams, John A.
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Susarla, Radhika
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Alonso-Perez, Irene
d8368707-6fea-4df6-81b5-0368f38b6549
Stratton, Irene M.
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Gkoutos, Georgios V.
b6932a93-1044-48c2-a211-0bf9053d35ec
Webber, Jonathan
a4037021-281f-41f1-adb7-1d9ad597ff3e
Luzio, Stephen D.
256a34ad-9e73-40df-93b3-e50bf5f6699e
Hanif, Wasim
486e55d6-ea90-4819-a617-632fe370edee
Roberts, Graham A.
ea00db4e-84e7-4b39-8273-9b71dbd7e2f3
Ghosh, Sandip, Manley, Susan E., Nightingale, Peter G., Williams, John A., Susarla, Radhika, Alonso-Perez, Irene, Stratton, Irene M., Gkoutos, Georgios V., Webber, Jonathan, Luzio, Stephen D., Hanif, Wasim and Roberts, Graham A.
(2020)
Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity.
Endocrinology, Diabetes and Metabolism, 3 (3), [e00140].
(doi:10.1002/edm2.140).
Abstract
Aims: to establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement.
Methods: electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance.
Results: three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P < .001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were ‘at risk’ (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P < .001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours.
Conclusions: hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions.
Text
Endocrino Diabet Metabol - 2020 - Ghosh - Prevalence of admission plasma glucose in diabetes or at risk ranges in
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More information
Accepted/In Press date: 4 April 2020
Published date: 15 May 2020
Additional Information:
Funding Information:: this study was performed by the Diabetes Translational Research Group and supported by: G. A. Roberts Research Fund and Queen Elizabeth Hospital Birmingham Charity. JAW received grants from National Human Genome Research Institute of National Institutes of Health, under award number UM1HG006370. GVG received grants from H2020-EINFRA (731075), National Science Foundation (IOS:1340112), NIHR Birmingham ECMC, NIHR Birmingham SRMRC, NIHR Birmingham Biomedical Research Centre and MRC HDR UK. The views expressed in this paper are those of the authors and not necessarily those of the NHS, National Institute for Health Research, Medical Research Council, Department of Health or US National Institutes of Health. The funding organizations had no role in the design of the study, data collection, analysis or interpretation, or preparation of manuscript, and did not approve/disapprove of, or delay publication. Laboratory measurements were produced by the biomedical scientists in Clinical Laboratory Sciences at Queen Elizabeth Hospital Birmingham. We would like to thank G. Gill (University Hospitals Birmingham NHS Foundation Trust) who performed the audit and R. A. Round (University Hospitals Birmingham NHS Foundation Trust) for their assistance with the manuscript.
Keywords:
emergency admissions, hyperglycaemia, undiagnosed diabetes
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Local EPrints ID: 487013
URI: http://eprints.soton.ac.uk/id/eprint/487013
ISSN: 2398-9238
PURE UUID: 31c53a0b-7af1-4006-b326-35ea11e63ded
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Date deposited: 09 Feb 2024 17:41
Last modified: 18 Mar 2024 04:01
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Contributors
Author:
Sandip Ghosh
Author:
Susan E. Manley
Author:
Peter G. Nightingale
Author:
John A. Williams
Author:
Radhika Susarla
Author:
Irene Alonso-Perez
Author:
Irene M. Stratton
Author:
Georgios V. Gkoutos
Author:
Jonathan Webber
Author:
Stephen D. Luzio
Author:
Wasim Hanif
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