Endocrine Abstracts

JOINT667

Introduction: Emergency admissions are stressful situations that can disrupt glycemic control in diabetic patients. These disruptions are often caused by multiple factors, such as the severity of the underlying condition, the physiological stress response involving cortisol and adrenaline secretion, and sometimes inadequate therapeutic adjustments in the hospital setting. Few studies have explored the impact of emergency admissions on glycemic control in diabetic patients, despite their potential implications for management and prevention of acute complications. This study aims to evaluate the impact of emergency admissions on glycemic control in hospitalized diabetic patients.

Patients and methods: We conducted a multicenter cross-sectional study between February and March 2024 in three Tunisian university hospitals: Hedi Chaker University Hospital in Sfax, Habib Bourguiba University Hospital in Sfax, and Taher Sfar University Hospital in Mahdia. The study included diabetic patients hospitalized in cardiology, pneumology, urology, general surgery, and orthopedic departments. Data collected included the reason for admission (emergency or elective), the occurrence of acute hyperglycemic complicaton or hypoglycemia, and the evaluation of glycemic control. Glycemic control was classified as insufficient if less than 50% of blood glucose readings (BGR) were within the intra-hospital glycemic target (defined by the ADA as 1–1.8 g/l), moderate if 50–70% of BGR were within the target, and satisfactory if more than 70% of BGR met the target.

Results: A total of 315 patients were included, two-thirds of whom were men. The median age was 65 years, and the median diabetes duration was 8 years. The majority (87%) had type 2 diabetes. Most patients (75.9%) were admitted via emergency departments. Acute hyperglycemic decompensation was diagnosed in 21% of patients, and hypoglycemia was observed in 20.6%. Among patients who underwent glycemic monitoring, 50.7% had insufficient glycemic control, while only 21.6% achieved satisfactory control. Emergency admissions did not significantly increase the risk of hyperglycemic decompensation (P = 0.631), although 78.5% of patients with decompensation had been admitted through emergency departments. The frequency of hypoglycemia was also comparable between emergency and elective admissions (P = 0.211). Similarly, emergency admission was not significantly associated with insufficient glycemic control (P=0.396).

Conclusion: This study demonstrates that while the majority of hospitalized diabetic patients were admitted through emergency departments, these admissions did not significantly influence the risk of hyperglycemic decompensation, hypoglycemia, or insufficient glycemic control.