title: Prevalence of dysglycaemic events among inpatients with diabetes mellitus: a Singaporean perspective.
abstract: BACKGROUND
  As the effectiveness of intensive glycaemic control is unclear and recommended glycaemic targets are inconsistent, this study aimed to ascertain the prevalence of dysglycaemia among hospitalised patients with diabetes mellitus in an Asian population and evaluate the current standards of inpatient glycaemic control.
  
  
  METHODS
  A retrospective observational study was conducted at a secondary hospital. Point-of-care blood glucose (BG) values, demographic data, medical history, glycaemic therapy and clinical characteristics were recorded. Dysglycaemia prevalence was calculated as proportions of BG-monitored days with at least one reading exceeding the cut points of 8, 10 and 15 mmol/L for hyperglycaemia, and below the cut point of 4 mmol/L for hypoglycaemia.
  
  
  RESULTS
  Among the 288 patients recruited, hyperglycaemia was highly prevalent (90.3%, 81.3% and 47.6% for the respective cut points), while hypoglycaemia was the least prevalent (18.8%). Dysglycaemic patients were more likely than normoglycaemic patients to have poorer glycated haemoglobin (HbA1c) levels (8.4% ± 2.6% vs. 7.3% ± 1.9%; p = 0.002 for BG > 10 mmol/L) and longer lengths of stay (10.1 ± 8.2 days vs. 6.8 ± 4.7 days; p = 0.007 for BG < 4 mmol/L). Hyperglycaemia was more prevalent in patients on more intensive treatment regimens, such as basal-bolus combination therapy and the use of both insulin and oral hypoglycaemic agents (100.0% and 96.0%, respectively; p < 0.001 for BG > 10 mmol/L).
  
  
  CONCLUSIONS
  Inpatient glycaemic control is suboptimal. Factors (e.g. type of treatment regimen, discipline and baseline HbA1c) associated with greater prevalence of dysglycaemia should be given due consideration in patient management.
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore ; Specialist Outpatient Clinics, Department of Pharmacy, Singapore General Hospital, Singapore.
authors.forename: Kheng Yong
authors.initials: KY
authors.lastname: Ong
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore ; Duke-NUS Graduate Medical School Singapore, Singapore.
authors.forename: Yu Heng
authors.initials: YH
authors.lastname: Kwan
authors.affiliation: Department of Pharmacy, Khoo Teck Puat Hospital, Singapore.
authors.forename: Hooi Ching
authors.initials: HC
authors.lastname: Tay
authors.affiliation: Department of Pharmacy, Khoo Teck Puat Hospital, Singapore.
authors.forename: Doreen Su-Yin
authors.initials: DS
authors.lastname: Tan
authors.affiliation: Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
authors.forename: Joanne Yeh
authors.initials: JY
authors.lastname: Chang
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006761:Hospitals; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000188:drug therapy; D007003:Hypoglycemia / Q000150:complications* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007297:Inpatients; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D015995:Prevalence; D012189:Retrospective Studies; D012846:Singapore; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: diabetes mellitus; dysglycaemia; hospital; hyperglycaemia; inpatients