Title:Association Between Intra-Hospital Uncontrolled Glycemia and Health Outcomes in Patients with Diabetes: A Systematic Review of Observational Studies
Volume: 17
Issue: 3
Author(s): Renata Cunha Carvalho*, Fernanda Ayache Nishi, Tatiane Bomfim Ribeiro, Gustavo Galvão França and Patricia Melo Aguiar
Affiliation:
- Division of Pharmacy of University Hospital, University of São Paulo, São Paulo,Brazil
Keywords:
Hyperglycemia, hypoglycemia, glycemic variability, inpatient, diabetes, outcome.
Abstract: Background: Many people are still getting affected by uncontrolled glycemic events during
hospital admission, which encompasses hypoglycemia, hyperglycemia, and high glycemic variability.
Introduction: Primary studies have shown an association of glycemic dysregulation with increased
length of hospital stay and mortality among overall patients, however, there is no systematic review of
current evidence on the association between uncontrolled in-hospital glycemia in patients with diabetes
and health outcomes. This study aimed to systematically review the current evidence on the association
between uncontrolled in-hospital glycemia in patients with diabetes and health outcomes.
Methods: The association between glycemic dysregulation and health outcomes for inpatients with diabetes
was systematically reviewed. PubMed, Embase, and LILACS databases were searched. Two independent
reviewers were involved in each of the following steps: screening titles, abstracts, and fulltexts;
assessing the methodological quality; and extracting data from included reviews. Descriptive
analysis method was used.
Results: Seven cohort studies were included, and only two had a prospective design, consisting of 7,174
hospitalized patients with diabetes. In-hospital occurrence of hypoglycemia, hyperglycemia, and glycemic
variability were assessed, and outcomes were mortality, infections, renal complications, and adverse
events. Among the exposure and outcomes, an association was observed between severe hypoglycemia
and mortality, hyperglycemia and infection, and hyperglycemia and adverse events.
Conclusion: In-hospital uncontrolled glycemia in patients with diabetes is associated with poor health
outcomes. More studies should be conducted for proper investigation because diabetes is a complex
condition. Effects of glycemic dysregulation should be investigated on the basis of overall health of a
patient instead from only organ-target perspective, which makes the investigation difficult.
