title: The high burden of inpatient diabetes mellitus: the Melbourne Public Hospitals Diabetes Inpatient Audit.
abstract: OBJECTIVE
  To determine the prevalence of diabetes in inpatients in Melbourne hospitals.
  
  
  METHODS
  Point prevalence survey of all inpatients in each hospital on a single day between 30 November 2010 and 22 November 2012.
  
  
  METHODS
  11 hospitals in metropolitan Melbourne including community, secondary and tertiary hospitals and one aged care and rehabilitation centre.
  
  
  METHODS
  2308 adult inpatients in all wards apart from intensive care, emergency, obstetrics and psychiatry.
  
  
  METHODS
  Point prevalence of self-reported diabetes, details of current medication, self-reported frequency of complications.
  
  
  RESULTS
  Diabetes status was obtained in 2273 of 2308 inpatients (98.5%). Of these, 562 (24.7%) had diabetes (95% CI, 22.9%-26.5%). Diabetes prevalence ranged from 15.7% to 35.1% in different hospitals (P < 0.001). Patients with diabetes were older, heavier and more likely to be taking lipid-lowering, antihypertensive and blood-thinning medications. Of 388 patients with complete medication information, 270 (69.6%) were taking oral hypoglycaemic agents alone or in combination with insulin, 158 (40.7%) were treated with insulin (67 [17.3%] with insulin alone) and 51 (13.1%) were not taking medication for diabetes. The frequency of diabetes complications was very high: 207/290 (71.4%) for any microvascular complication, 275/527 (52.2%) for any macrovascular complication and 227/276 (82.2%) for any complication.
  
  
  CONCLUSIONS
  The high burden of diabetes in Melbourne hospital inpatients has major implications for patient health and health care expenditure. Optimising care of these high-risk patients has the potential to decrease inpatient morbidity and length of stay as well as preventing or delaying future complications. A formal Australian national audit of inpatient diabetes would determine its true prevalence and consequences, allowing rational planning to deal with shortcomings in its management.
authors.affiliation: Alfred Health, Melbourne, VIC, Australia. leon.bach@monash.edu.
authors.forename: Leon A
authors.initials: LA
authors.lastname: Bach
authors.affiliation: Austin Health, Melbourne, VIC, Australia.
authors.forename: Elif I
authors.initials: EI
authors.lastname: Ekinci
authors.affiliation: Monash Health, Melbourne, VIC, Australia.
authors.forename: Dennis
authors.initials: D
authors.lastname: Engler
authors.affiliation: Eastern Health, Melbourne, VIC, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Gilfillan
authors.affiliation: Western Health, Melbourne, VIC, Australia.
authors.forename: P Shane
authors.initials: PS
authors.lastname: Hamblin
authors.affiliation: St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: MacIsaac
authors.affiliation: Monash Health, Melbourne, VIC, Australia.
authors.forename: Georgia
authors.initials: G
authors.lastname: Soldatos
authors.affiliation: Western Health, Melbourne, VIC, Australia.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Steele
authors.affiliation: St Vincent's Hospital, Melbourne, VIC, Australia.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Ward
authors.affiliation: Alfred Health, Melbourne, VIC, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Wyatt
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006779:Hospitals, Public; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D014739:Victoria