Portal de Periódicos da CAPES

Hyperglycaemia in acutely ill non-diabetics

2013; Elsevier BV; Volume: 24; Linguagem: Inglês

10.1016/j.ejim.2013.08.257

1879-0828

Rosa Cardiga, M. Fernanda R. P. Proença, F. Marques, Inês Araújo, M. Alface, Jessica A. Rodrigues, Sérgio Augusto, Cândida Fonseca, Ana Lúcia Leitão, Fátima Ceia,

Diabetes Management and Research

Introduction: Diabetes mellitus (DM) is an independent predictor of mortality in hospitalized patients (pts). Prospective observational studies have reported a greater association between hyperglycaemia and increased mortality in non-diabetic pts compared with diabetics. Objectives: To compare the clinical characteristics and prognosis of non-diabetic vs. diabetic pts with hyperglycaemia in an internal medicine ward. Methods: Prospective study of consecutively admitted pts with a diagnosis of type 2 DM — Group A — vs. non-diabetic pts with hyperglycaemia (at least one occasional glucose ≥200 mg/dl or fasting glucose ≥126 mg/dl in the acute phase) — Group B. We compared prevalence, clinical characteristics and in-hospital and long-term mortality (277.6 ± 186.5 days). Results: 306 pts were included. Group A (175, 57.2%) vs. Group B (131, 42.8%); prevalence 30.8% vs. 23.8%, men 46.9 vs. 42.7% (ns); age 75.1 ± 11.6 vs. 77.2 ± 13.4 years old (ns), and BMI 27.9 ± 5.9 vs. 25.1 ± 4.8 kg/m2 (p = 0.001). Comorbidities A vs. B: hypertension 86.9 vs. 74.0% (p = 0.007); coronary disease 35.4 vs. 19.8% (p = 0.004), heart failure 65.1 vs. 39.7% (p = 0.001), peripheral artery disease 11.4 vs. 9.4% (ns), cerebrovascular disease 19.4 vs. 25.2% (ns), chronic kidney disease 51.4 vs. 40.5% (ns), and Charlson index 8.0 ± 2.6 vs. 6.6 ± 3.0 (p = 0.001). In-hospital mortality A vs. B: 3.4 vs. 12.2% (p = 0.007); long-term mortality A vs. B: 23.5 vs. 36.6% (p = 0.03). 14.7% of pts with hyperglycaemia met criteria for type 2 DM. Conclusion: Hyperglycaemia occurred in almost a quarter of acutely ill pts admitted in an internal medicine ward. Although significantly less obese and with fewer comorbidities, non-diabetic pts with hyperglycaemia had a significantly worse short and long-term prognosis than diabetics. This important issue and the potential benefit of correction of glycaemia in these patients deserve assessment in large, randomized, and multicentre studies.