HbA1C Test Detects Undiagnosed Diabetes in Hospitalized Patients with Hyperglycemia

Administering an HbA1C test to hospitalized patients with hyperglycemia is a cost-effective way to uncover diabetes in those without a history of the disease, according to a study in the June issue of The Journal of the American Osteopathic Association.

“In the hospital, we often find hyperglycemia when we are treating other illnesses, like sepsis or a heart attack,” said researcher Jay H. Shubrook, DO, a professor at Touro University California. “This study found that patients with no known history of diabetes whose HbA1C level was measured were 5 times more likely to leave the hospital with a diagnosis of new-onset diabetes.”

For the study, researchers from Touro University California and Ohio University Heritage College of Osteopathic Medicine reviewed medical records of 348 patients admitted to a rural community teaching hospital with hyperglycemia. Fifty had no known history of diabetes, and 31 of them received an HbA1C test. HbA1C tests measure average blood glucose level over the previous 2 to 3 months.

The review revealed that 77% of the 31 patients who received the test had results consistent with diabetes (58%) or prediabetes (19%). Seventeen of them, or 55%, were discharged with a diagnosis that included diabetes.

Comparatively, just 2 of the 19 patients with hyperglycemia and no known history of diabetes who did not receive an HbA1C test had a discharge diagnosis that included diabetes, according to the study.

“That shows us we are missing opportunities to detect diabetes and initiate treatment for those patients to help manage that disease, which can reduce their long-term cost of care and disease burden,” Dr Shubrook said. “From the osteopathic perspective of early detection equals better outcomes, it is easy to make a case for hospital protocols to trigger an HbA1C test when hyperglycemia is detected to distinguish between transient hyperglycemia and chronic disease.”—Jolynn Tumolo

References

1. Jones D, Scharfenberg B, Perkins J, Childers K, Dogbey GY, Shubrook JH.Glycated hemoglobin testing to identify undiagnosed diabetes mellitus in the inpatient setting. The Journal of the American Osteopathic Association. 2016;116:350-357.
    
2. Blood test uncovers undiagnosed diabetes in hospital patients with high blood sugar [press release]. PR Newswire: Chicago; May 23, 2016.