Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity

Sandip Ghosh; Susan E. Manley; Peter G. Nightingale; John A. Williams; Radhika Susarla; Irene Alonso‐Perez; Irene M. Stratton; Georgios V. Gkoutos; Jonathan Webber; Stephen D. Luzio; Wasim Hanif; Graham A. Roberts

doi:10.1002/edm2.140

Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity

Sandip Ghosh, Susan E. Manley, Peter G. Nightingale, John A. Williams, Radhika Susarla, Irene Alonso‐Perez, Irene M. Stratton, Georgios V. Gkoutos, Jonathan Webber, Stephen D. Luzio, Wasim Hanif, Graham A. Roberts

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Abstract

Aims: To establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement.

Methods: Electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance.

Results: Three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P <.001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were ‘at risk’ (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P <.001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours.

Conclusions: Hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions.

Original language	English
Article number	e00140
Number of pages	10
Journal	Endocrinology, Diabetes & Metabolism
Volume	3
Issue number	3
Early online date	15 May 2020
DOIs	https://doi.org/10.1002/edm2.140
Publication status	Published - Jul 2020

Bibliographical note

Funding Information:
This study was performed?by the?Diabetes Translational Research Group and supported by: G. A. Roberts Research Fund and Queen Elizabeth Hospital Birmingham Charity. JAW received grants from National Human Genome Research Institute of National Institutes of Health, under award number UM1HG006370. GVG received grants from H2020-EINFRA (731075), National Science Foundation (IOS:1340112), NIHR Birmingham ECMC, NIHR Birmingham SRMRC, NIHR Birmingham Biomedical Research Centre and MRC HDR UK. The views expressed in this paper are those of the authors and not necessarily those of the NHS, National Institute for Health Research, Medical Research Council, Department of Health or US National Institutes of Health. The funding organizations had no role in the design of the study, data collection, analysis or interpretation, or preparation of manuscript, and did not approve/disapprove of, or delay publication. Laboratory measurements were produced by the biomedical scientists in Clinical Laboratory Sciences at Queen Elizabeth Hospital Birmingham. We would like to thank G. Gill (University Hospitals Birmingham NHS Foundation Trust) who performed the audit?and R. A. Round (University Hospitals Birmingham NHS Foundation Trust) for their assistance with the manuscript.

Publisher Copyright:
© 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

Keywords

emergency admissions
hyperglycaemia
undiagnosed diabetes

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism

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Cite this

Ghosh, S., Manley, S. E., Nightingale, P. G., Williams, J. A., Susarla, R., Alonso‐Perez, I., Stratton, I. M., Gkoutos, G. V., Webber, J., Luzio, S. D., Hanif, W., & Roberts, G. A. (2020). Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity. Endocrinology, Diabetes & Metabolism, 3(3), Article e00140. https://doi.org/10.1002/edm2.140

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title = "Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity",

abstract = "Aims: To establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement. Methods: Electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance. Results: Three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P <.001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were {\textquoteleft}at risk{\textquoteright} (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P <.001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours. Conclusions: Hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions.",

keywords = "emergency admissions, hyperglycaemia, undiagnosed diabetes",

author = "Sandip Ghosh and Manley, {Susan E.} and Nightingale, {Peter G.} and Williams, {John A.} and Radhika Susarla and Irene Alonso‐Perez and Stratton, {Irene M.} and Gkoutos, {Georgios V.} and Jonathan Webber and Luzio, {Stephen D.} and Wasim Hanif and Roberts, {Graham A.}",

note = "Funding Information: This study was performed?by the?Diabetes Translational Research Group and supported by: G. A. Roberts Research Fund and Queen Elizabeth Hospital Birmingham Charity. JAW received grants from National Human Genome Research Institute of National Institutes of Health, under award number UM1HG006370. GVG received grants from H2020-EINFRA (731075), National Science Foundation (IOS:1340112), NIHR Birmingham ECMC, NIHR Birmingham SRMRC, NIHR Birmingham Biomedical Research Centre and MRC HDR UK. The views expressed in this paper are those of the authors and not necessarily those of the NHS, National Institute for Health Research, Medical Research Council, Department of Health or US National Institutes of Health. The funding organizations had no role in the design of the study, data collection, analysis or interpretation, or preparation of manuscript, and did not approve/disapprove of, or delay publication. Laboratory measurements were produced by the biomedical scientists in Clinical Laboratory Sciences at Queen Elizabeth Hospital Birmingham. We would like to thank G. Gill (University Hospitals Birmingham NHS Foundation Trust) who performed the audit?and R. A. Round (University Hospitals Birmingham NHS Foundation Trust) for their assistance with the manuscript. Publisher Copyright: {\textcopyright} 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.",

year = "2020",

month = jul,

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Ghosh, S, Manley, SE, Nightingale, PG, Williams, JA, Susarla, R, Alonso‐Perez, I, Stratton, IM, Gkoutos, GV, Webber, J, Luzio, SD, Hanif, W & Roberts, GA 2020, 'Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity', Endocrinology, Diabetes & Metabolism, vol. 3, no. 3, e00140. https://doi.org/10.1002/edm2.140

TY - JOUR

T1 - Prevalence of admission plasma glucose in 'diabetes' or 'at risk' ranges in hospital emergencies with no prior diagnosis of diabetes by gender, age and ethnicity

AU - Ghosh, Sandip

AU - Manley, Susan E.

AU - Nightingale, Peter G.

AU - Williams, John A.

AU - Susarla, Radhika

AU - Alonso‐Perez, Irene

AU - Stratton, Irene M.

AU - Gkoutos, Georgios V.

AU - Webber, Jonathan

AU - Luzio, Stephen D.

AU - Hanif, Wasim

AU - Roberts, Graham A.

N1 - Funding Information: This study was performed?by the?Diabetes Translational Research Group and supported by: G. A. Roberts Research Fund and Queen Elizabeth Hospital Birmingham Charity. JAW received grants from National Human Genome Research Institute of National Institutes of Health, under award number UM1HG006370. GVG received grants from H2020-EINFRA (731075), National Science Foundation (IOS:1340112), NIHR Birmingham ECMC, NIHR Birmingham SRMRC, NIHR Birmingham Biomedical Research Centre and MRC HDR UK. The views expressed in this paper are those of the authors and not necessarily those of the NHS, National Institute for Health Research, Medical Research Council, Department of Health or US National Institutes of Health. The funding organizations had no role in the design of the study, data collection, analysis or interpretation, or preparation of manuscript, and did not approve/disapprove of, or delay publication. Laboratory measurements were produced by the biomedical scientists in Clinical Laboratory Sciences at Queen Elizabeth Hospital Birmingham. We would like to thank G. Gill (University Hospitals Birmingham NHS Foundation Trust) who performed the audit?and R. A. Round (University Hospitals Birmingham NHS Foundation Trust) for their assistance with the manuscript. Publisher Copyright: © 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

PY - 2020/7

Y1 - 2020/7

N2 - Aims: To establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement. Methods: Electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance. Results: Three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P <.001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were ‘at risk’ (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P <.001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours. Conclusions: Hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions.

AB - Aims: To establish the prevalence of admission plasma glucose in 'diabetes' and 'at risk' ranges in emergency hospital admissions with no prior diagnosis of diabetes; characteristics of people with hyperglycaemia; and factors influencing glucose measurement. Methods: Electronic patient records for 113 097 hospital admissions over 1 year from 2014 to 2015 included 43 201 emergencies with glucose available for 31 927 (74%) admissions, comprising 22 045 people. Data are presented for 18 965 people with no prior diagnosis of diabetes and glucose available on first attendance. Results: Three quarters (14 214) were White Europeans aged 62 (43-78) years, median (IQ range); 12% (2241) South Asians 46 (32-64) years; 9% (1726) Unknown/Other ethnicities 43 (29-61) years; and 4% (784) Afro-Caribbeans 49 (33-63) years, P <.001. Overall, 5% (1003) had glucose in the 'diabetes' range (≥11.1 mmol/L) higher at 8% (175) for South Asians; 16% (3042) were ‘at risk’ (7.8-11.0 mmol/L), that is 17% (2379) White Europeans, 15% (338) South Asians, 14% (236) Unknown/Others and 11% (89) Afro-Caribbeans, P <.001. The prevalence for South Asians aged <30 years was 2.1% and 5.2%, respectively, 2.6% and 8.6% for Afro-Caribbeans <30 years, and 2.0% and 8.4% for White Europeans <40 years. Glucose increased with age and was more often in the 'diabetes' range for South Asians than White Europeans with South Asian men particularly affected. One third of all emergency admissions were for <24 hours with 58% of these having glucose measured compared to 82% with duration >24 hours. Conclusions: Hyperglycaemia was evident in 21% of adults admitted as an emergency; various aspects related to follow-up and initial testing, age and ethnicity need to be considered by professional bodies addressing undiagnosed diabetes in hospital admissions.

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KW - hyperglycaemia

KW - undiagnosed diabetes

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