Testing, testing

Blood test uncovers undiagnosed diabetes in hospital patients

JAOA study finds HbA1C test leads to diabetes diagnosis for a significant percentage of hospitalized patients with hyperglycemia.

Patients admitted to the hospital for one aliment could find themselves leaving with a new diagnosis—diabetes.

A retrospective review of medical records, recently published in The Journal of the American Osteopathic Association (JAOA), found the glycated hemoglobin, or HbA1C, test used to diagnose and manage diabetes can effectively detect hidden disease among hospital patients with hyperglycemia.

“In the hospital, we often find hyperglycemia when we’re treating other illnesses, like sepsis or a heart attack,” says co-author Jay Shubrook, DO, a professor and director of clinical research and diabetes services at the Touro University California, College of Osteopathic Medicine (TUCOM) in Vallejo.

Researchers from TUCOM and the Ohio University Heritage College of Osteopathic Medicine at Athens reviewed the medical records of 348 patients with hyperglycemia discovered at admission in a rural community teaching hospital in the Midwest. Of those patients, 50 had no known history of diabetes and 31 of them were given an HbA1C test.

Among those tested:

  • 58% had results consistent with diagnoses of diabetes.
  • 19% had results consistent with diagnoses of prediabetes.
  • More than half (55%) of patients with no previous history of diabetes received a discharge diagnosis that included diabetes.

“These findings show 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 says. “It’s 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.”

Read the JAOA review to learn more about the researchers’ findings.

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