Blood Test Finds Undiagnosed Diabetes in Hospital Patients

Finding diabetes and treating it early can prevent high healthcare costs in the long term, the authors day.

A study published in the Journal of the American Osteopathic Association finds that the test for glycated hemoglobin (A1C) can be used to detect undiagnosed diabetes among patients with hyperglycemia, or high blood sugar.

Researchers reviewed medical records of 348 patients with hyperglycemia, who were admitted to a rural community teaching hospital. Of the group, 50 patients had no known history of diabetes, and 31 were given the A1C test, which measures blood glucose levels over the previous 8 to 12 weeks.

Among those tested, 77% had results consistent with diabetes (58%) or prediabetes (19%). More than half (55%) were discharged with a diagnosis including diabetes, despite no history of this disease in existing records.

“In the hospital, we often find hyperglycemia when we’re treating other illnesses, like sepsis or heart attack,” said Jay Shurbrook, DO, a professor of primary care at Touro University in California. “This study found that patients with no known history of diabetes whose A1C level was measured were more than 5 times more likely to leave the hospital with a diagnosis of new onset diabetes.”

Shurbrook said the study shows there are opportunities to find those with diabetes and treat them, reducing high healthcare expenditures over the long term. In addition, the finding of a sizable number of patients with prediabetes also affords providers a chance to intervene before full-blown diabetes develops.

“From the osteopathic perspective of early detection equals better outcomes, it’s easy to make a case for hospital protocols to trigger an A1C test when hyperglycemia is detected, to distinguish between transient hyperglycemia and chronic disease.”

The American Diabetes Association reported that 20% of healthcare dollars are spent on diabetes, including $1 of every $3 spent by Medicare. The authors said in a statement that earlier studies show that once diabetes is detected, proper inpatient education can lower rates of all-cause 30-day readmission.

Reference

Jones D, Scharfenberg B, Perkins J, Childers K, Dogbey GY, Shurbrook JH. Glycated hemoglobin testing to identify undiagnosed diabetes mellitus in the inpatient setting. J Am Osteopath Assoc. 2016;116:350-357.