Endocrine Abstracts

JOINT3539

Introduction: A significant proportion of hospitalized patients have some form of diabetes mellitus (DM). Achieving optimal glycemic control in hospitalized patients requires consideration of multiple factors, including food intake, fasting for tests/procedures, clinical deterioration, and corticosteroid use. Blood glucose levels outside the safe range (140 mg/dL–180 mg/dL) increase the risk of complications during hospitalization.

Objectives: To describe the characteristics of diabetic patients evaluated in the Endocrinology and Nutrition consultations at the Hospital Universitario de Canarias (HUC).

Materials and Methods: A descriptive observational study was conducted on a sample of 118 diabetic patients monitored through Endocrinology and Nutrition consultations at HUC from October to December 2024. The variables analyzed included age, sex, type of diabetes, referring hospital department, blood glucose levels at initial and final evaluations, HbA1c, treatment, associated comorbidities, and follow-up plan.

Results: A total of 53 women and 65 men were studied, with most patients aged 70–80 years (31%) and an average age of 65 years. Among them, 90 patients (76%) had type 2 diabetes (T2DM), 25 (21%) had type 1 diabetes (T1DM), and 3 (3%) had latent autoimmune diabetes in adults (LADA). The hospital department requesting the most consultations was Vascular Surgery (14%), followed by Gastroenterology (13%) and Nephrology (11%). At the initial evaluation, 29% of patients had blood glucose levels between 250–300 mg/dL, while 16% had levels exceeding 400 mg/dL. Before the endocrinology assessment, 44% of patients were on a sliding-scale insulin regimen, but 74% required an immediate transition to a basal-bolus insulin regimen. When analyzing blood glucose levels, it was noted that 31% of patients were receiving corticosteroids. Regarding HbA1c levels, 27% of patients had values between 7% and 8% (mean: 8.28%), while 14% had HbA1c levels >10%. Among the associated comorbidities, 37% had diabetic retinopathy, 43% had nephropathy, and 24% had polyneuropathy. For follow-up after discharge: 28% were referred to primary care physicians. 52% were scheduled for endocrinology outpatient follow-up. The remaining 20% included deceased patients, patients discharged without notification, voluntary discharges, and those followed up outside the island.

Conclusions: The limited effectiveness of sliding-scale insulin regimens in hospitalized patients is demonstrated. Maintaining blood glucose levels between 140 and 180 mg/dL is a safe target for hospitalized patients. Strengthening adherence to glycemic control protocols in hospitalized patients is essential. Additionally, hospitalization provides an opportunity to reinforce diabetes education, optimize home treatment, and assess follow-up needs upon discharge.