Endocrine Abstracts

Background: Diabetes mellitus (DM) accounts for around 20% of hospital admissions. Early measurement of blood glucose and ketone levels is crucial to detect metabolic complications. This study evaluated adherence to Joint British Diabetes Societies for Inpatient Care (JBDS-IP) and American Diabetes Association (ADA) guidelines, which recommend universal glucose and ketone testing at initial presentation in hospitalised diabetic patients.

Methods: We retrospectively reviewed 100 diabetic patients admitted over three months via the emergency department. Inclusion criteria were age ≥16 years and hospital stay >24 hours. Patients with advanced renal failure, pregnancy, severe anaemia, major blood loss, or haemoglobinopathies were excluded. Data were collected from electronic medical records. Statistical analysis (SPSS v 22) included descriptive statistics, Mann-Whitney U, chi-square, and t-tests. Multiple linear regression assessed predictors of log-transformed length of stay (LOS), and logistic regression evaluated factors influencing glucose testing.

Results: Among 100 patients (median age 59.5 years; 46% female), 28% had type 1 and 72% type 2 DM. Blood glucose was measured in 74% and ketones in 62%. Four patients (4%) missed both tests and developed metabolic acidosis. Type 2 DM patients were older than those with type 1 (median 67 vs 42 years, P < 0.001). Median LOS was 8 days, with no significant differences by DM type (P = 0.86) or sex (P = 0.85). Regression models for LOS (P = 0.50) and glucose testing (P = 0.26) were non-significant.

Conclusion: Adherence to JBDS-IP and ADA testing guidelines was suboptimal, with missed testing potentially contributing to preventable complications. Educational interventions are planned, with re-audit scheduled to assess impact.