Stress hyperglycaemia in hospitalised patients and their 3-year risk of diabetes: a Scottish retrospective cohort study
Hyperglycaemia during hospital admission is common in patients who are not known to have diabetes and is associated with adverse outcomes. The risk of subsequently developing type 2 diabetes, however, is not known. We linked a national database of hospital admissions with a national register of diab...
Gespeichert in:
| Veröffentlicht in: | PLoS medicine 2014-08, Vol.11 (8), p.e1001708-e1001708 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e1001708 |
|---|---|
| container_issue | 8 |
| container_start_page | e1001708 |
| container_title | PLoS medicine |
| container_volume | 11 |
| creator | McAllister, David A Hughes, Katherine A Lone, Nazir Mills, Nicholas L Sattar, Naveed McKnight, John Wild, Sarah H |
| description | Hyperglycaemia during hospital admission is common in patients who are not known to have diabetes and is associated with adverse outcomes. The risk of subsequently developing type 2 diabetes, however, is not known. We linked a national database of hospital admissions with a national register of diabetes to describe the association between admission glucose and the risk of subsequently developing type 2 diabetes.
In a retrospective cohort study, patients aged 30 years or older with an emergency admission to hospital between 2004 and 2008 were included. Prevalent and incident diabetes were identified through the Scottish Care Information (SCI)-Diabetes Collaboration national registry. Patients diagnosed prior to or up to 30 days after hospitalisation were defined as prevalent diabetes and were excluded. The predicted risk of developing incident type 2 diabetes during the 3 years following hospital discharge by admission glucose, age, and sex was obtained from logistic regression models. We performed separate analyses for patients aged 40 and older, and patients aged 30 to 39 years. Glucose was measured in 86,634 (71.0%) patients aged 40 and older on admission to hospital. The 3-year risk of developing type 2 diabetes was 2.3% (1,952/86,512) overall, was 15 mmol/l had higher mortality than patients with a glucose of |
| doi_str_mv | 10.1371/journal.pmed.1001708 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1685382854</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A382807176</galeid><doaj_id>oai_doaj_org_article_82bf5631178a4317b6a60b5575c2181b</doaj_id><sourcerecordid>A382807176</sourcerecordid><originalsourceid>FETCH-LOGICAL-c736t-948298880ea4e0ff1e891d25a8347267f8bfc30991b02c34c71708651ffc78d53</originalsourceid><addsrcrecordid>eNqVk12L1DAUhoso7rr6D0QDguhFx6RpmtQLYVn8GFhccNTbkKanbdZOU5N0df69GWd2mcJcKLlIOHnOe5LzkSRPCV4Qysmbazu5QfWLcQ31gmBMOBb3klPC8jIlBS_uH5xPkkfeX2OclbjED5OTjBFaCFyeJr9WwYH3qNuM4Np-oxWsjUJmQJ31owmqNx5qNKpgYAgeqaFGoQPjEE03oBxyxv9AtkG1URUE8G-RQittQzC-Qw6CizKgg7kBpG1nXUA-TPXmcfKgUb2HJ_v9LPn24f3Xi0_p5dXH5cX5Zao5LUJa5iIrhRAYVA64aQiIktQZU4LmPCt4I6pGU1yWpMKZprnm2zQUjDSN5qJm9Cx5vtMde-vlPmdekkIwKjLB8kgsd0Rt1bUcnVkrt5FWGfnXYF0rlQtG9yBFVjWsoIRwoXJKeFWoAleMcaYzIkgVtd7to01VLIuOKXOqn4nObwbTydbeyJxQgSmOAq_2As7-nMAHuTZeQ9-rAewU380Yy3KBcx7RFzu0VfFpZmhsVNRbXJ5vv4ZjKopIpUeoFgaI4e0AjYnmGb84wsdVx77QRx1ezxwiE-B3aNXkvVyuvvwH-_nf2avvc_blAduB6kPnbT8FYwc_B_MdqGNbegfNXWkIltupuu0QuZ0quZ-q6PbssKx3TrdjRP8AgIEcBQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1555248047</pqid></control><display><type>article</type><title>Stress hyperglycaemia in hospitalised patients and their 3-year risk of diabetes: a Scottish retrospective cohort study</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>McAllister, David A ; Hughes, Katherine A ; Lone, Nazir ; Mills, Nicholas L ; Sattar, Naveed ; McKnight, John ; Wild, Sarah H</creator><creatorcontrib>McAllister, David A ; Hughes, Katherine A ; Lone, Nazir ; Mills, Nicholas L ; Sattar, Naveed ; McKnight, John ; Wild, Sarah H</creatorcontrib><description>Hyperglycaemia during hospital admission is common in patients who are not known to have diabetes and is associated with adverse outcomes. The risk of subsequently developing type 2 diabetes, however, is not known. We linked a national database of hospital admissions with a national register of diabetes to describe the association between admission glucose and the risk of subsequently developing type 2 diabetes.
In a retrospective cohort study, patients aged 30 years or older with an emergency admission to hospital between 2004 and 2008 were included. Prevalent and incident diabetes were identified through the Scottish Care Information (SCI)-Diabetes Collaboration national registry. Patients diagnosed prior to or up to 30 days after hospitalisation were defined as prevalent diabetes and were excluded. The predicted risk of developing incident type 2 diabetes during the 3 years following hospital discharge by admission glucose, age, and sex was obtained from logistic regression models. We performed separate analyses for patients aged 40 and older, and patients aged 30 to 39 years. Glucose was measured in 86,634 (71.0%) patients aged 40 and older on admission to hospital. The 3-year risk of developing type 2 diabetes was 2.3% (1,952/86,512) overall, was <1% for a glucose ≤ 5 mmol/l, and increased to approximately 15% at 15 mmol/l. The risks at 7 mmol/l and 11.1 mmol/l were 2.6% (95% CI 2.5-2.7) and 9.9% (95% CI 9.2-10.6), respectively, with one in four (21,828/86,512) and one in 40 (1,798/86,512) patients having glucose levels above each of these cut-points. For patients aged 30-39, the risks at 7 mmol/l and 11.1 mmol/l were 1.0% (95% CI 0.8-1.3) and 7.8% (95% CI 5.7-10.7), respectively, with one in eight (1,588/11,875) and one in 100 (120/11,875) having glucose levels above each of these cut-points. The risk of diabetes was also associated with age, sex, and socio-economic deprivation, but not with specialty (medical versus surgical), raised white cell count, or co-morbidity. Similar results were obtained for pre-specified sub-groups admitted with myocardial infarction, chronic obstructive pulmonary disease, and stroke. There were 25,193 deaths (85.8 per 1,000 person-years) over 297,122 person-years, of which 2,406 (8.1 per 1,000 person-years) were attributed to vascular disease. Patients with glucose levels of 11.1 to 15 mmol/l and >15 mmol/l had higher mortality than patients with a glucose of <6.1 mmol/l (hazard ratio 1.54; 95% CI 1.42-1.68 and 2.50; 95% CI 2.14-2.95, respectively) in models adjusting for age and sex. Limitations of our study include that we did not have data on ethnicity or body mass index, which may have improved prediction and the results have not been validated in non-white populations or populations outside of Scotland.
Plasma glucose measured during an emergency hospital admission predicts subsequent risk of developing type 2 diabetes. Mortality was also 1.5-fold higher in patients with elevated glucose levels. Our findings can be used to inform patients of their long-term risk of type 2 diabetes, and to target lifestyle advice to those patients at highest risk. Please see later in the article for the Editors' Summary.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1001708</identifier><identifier>PMID: 25136809</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age ; Age Factors ; Aged ; Aged, 80 and over ; Blood Glucose - analysis ; Cohort Studies ; Collaboration ; Complications and side effects ; Diabetes ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - etiology ; Diabetes Mellitus, Type 2 - mortality ; Female ; Glucose ; Hospital care ; Hospitalization ; Hospitals ; Humans ; Hyperglycemia ; Hyperglycemia - blood ; Hyperglycemia - epidemiology ; Hyperglycemia - etiology ; Hyperglycemia - mortality ; Illnesses ; Lifestyles ; Logistic Models ; Male ; Medical research ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Patient admissions ; Retrospective Studies ; Risk ; Risk factors ; Scotland - epidemiology ; Sex Factors ; Socioeconomic Factors ; Statistics ; Studies ; Time Factors</subject><ispartof>PLoS medicine, 2014-08, Vol.11 (8), p.e1001708-e1001708</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 McAllister et al 2014 McAllister et al</rights><rights>2014 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: McAllister DA, Hughes KA, Lone N, Mills NL, Sattar N, McKnight J, et al. (2014) Stress Hyperglycaemia in Hospitalised Patients and Their 3-Year Risk of Diabetes: A Scottish Retrospective Cohort Study. PLoS Med 11(8): e1001708. doi:10.1371/journal.pmed.1001708</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c736t-948298880ea4e0ff1e891d25a8347267f8bfc30991b02c34c71708651ffc78d53</citedby><cites>FETCH-LOGICAL-c736t-948298880ea4e0ff1e891d25a8347267f8bfc30991b02c34c71708651ffc78d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138030/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138030/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25136809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McAllister, David A</creatorcontrib><creatorcontrib>Hughes, Katherine A</creatorcontrib><creatorcontrib>Lone, Nazir</creatorcontrib><creatorcontrib>Mills, Nicholas L</creatorcontrib><creatorcontrib>Sattar, Naveed</creatorcontrib><creatorcontrib>McKnight, John</creatorcontrib><creatorcontrib>Wild, Sarah H</creatorcontrib><title>Stress hyperglycaemia in hospitalised patients and their 3-year risk of diabetes: a Scottish retrospective cohort study</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Hyperglycaemia during hospital admission is common in patients who are not known to have diabetes and is associated with adverse outcomes. The risk of subsequently developing type 2 diabetes, however, is not known. We linked a national database of hospital admissions with a national register of diabetes to describe the association between admission glucose and the risk of subsequently developing type 2 diabetes.
In a retrospective cohort study, patients aged 30 years or older with an emergency admission to hospital between 2004 and 2008 were included. Prevalent and incident diabetes were identified through the Scottish Care Information (SCI)-Diabetes Collaboration national registry. Patients diagnosed prior to or up to 30 days after hospitalisation were defined as prevalent diabetes and were excluded. The predicted risk of developing incident type 2 diabetes during the 3 years following hospital discharge by admission glucose, age, and sex was obtained from logistic regression models. We performed separate analyses for patients aged 40 and older, and patients aged 30 to 39 years. Glucose was measured in 86,634 (71.0%) patients aged 40 and older on admission to hospital. The 3-year risk of developing type 2 diabetes was 2.3% (1,952/86,512) overall, was <1% for a glucose ≤ 5 mmol/l, and increased to approximately 15% at 15 mmol/l. The risks at 7 mmol/l and 11.1 mmol/l were 2.6% (95% CI 2.5-2.7) and 9.9% (95% CI 9.2-10.6), respectively, with one in four (21,828/86,512) and one in 40 (1,798/86,512) patients having glucose levels above each of these cut-points. For patients aged 30-39, the risks at 7 mmol/l and 11.1 mmol/l were 1.0% (95% CI 0.8-1.3) and 7.8% (95% CI 5.7-10.7), respectively, with one in eight (1,588/11,875) and one in 100 (120/11,875) having glucose levels above each of these cut-points. The risk of diabetes was also associated with age, sex, and socio-economic deprivation, but not with specialty (medical versus surgical), raised white cell count, or co-morbidity. Similar results were obtained for pre-specified sub-groups admitted with myocardial infarction, chronic obstructive pulmonary disease, and stroke. There were 25,193 deaths (85.8 per 1,000 person-years) over 297,122 person-years, of which 2,406 (8.1 per 1,000 person-years) were attributed to vascular disease. Patients with glucose levels of 11.1 to 15 mmol/l and >15 mmol/l had higher mortality than patients with a glucose of <6.1 mmol/l (hazard ratio 1.54; 95% CI 1.42-1.68 and 2.50; 95% CI 2.14-2.95, respectively) in models adjusting for age and sex. Limitations of our study include that we did not have data on ethnicity or body mass index, which may have improved prediction and the results have not been validated in non-white populations or populations outside of Scotland.
Plasma glucose measured during an emergency hospital admission predicts subsequent risk of developing type 2 diabetes. Mortality was also 1.5-fold higher in patients with elevated glucose levels. Our findings can be used to inform patients of their long-term risk of type 2 diabetes, and to target lifestyle advice to those patients at highest risk. Please see later in the article for the Editors' Summary.</description><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Glucose - analysis</subject><subject>Cohort Studies</subject><subject>Collaboration</subject><subject>Complications and side effects</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - etiology</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Female</subject><subject>Glucose</subject><subject>Hospital care</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - blood</subject><subject>Hyperglycemia - epidemiology</subject><subject>Hyperglycemia - etiology</subject><subject>Hyperglycemia - mortality</subject><subject>Illnesses</subject><subject>Lifestyles</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patient admissions</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Scotland - epidemiology</subject><subject>Sex Factors</subject><subject>Socioeconomic Factors</subject><subject>Statistics</subject><subject>Studies</subject><subject>Time Factors</subject><issn>1549-1676</issn><issn>1549-1277</issn><issn>1549-1676</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNqVk12L1DAUhoso7rr6D0QDguhFx6RpmtQLYVn8GFhccNTbkKanbdZOU5N0df69GWd2mcJcKLlIOHnOe5LzkSRPCV4Qysmbazu5QfWLcQ31gmBMOBb3klPC8jIlBS_uH5xPkkfeX2OclbjED5OTjBFaCFyeJr9WwYH3qNuM4Np-oxWsjUJmQJ31owmqNx5qNKpgYAgeqaFGoQPjEE03oBxyxv9AtkG1URUE8G-RQittQzC-Qw6CizKgg7kBpG1nXUA-TPXmcfKgUb2HJ_v9LPn24f3Xi0_p5dXH5cX5Zao5LUJa5iIrhRAYVA64aQiIktQZU4LmPCt4I6pGU1yWpMKZprnm2zQUjDSN5qJm9Cx5vtMde-vlPmdekkIwKjLB8kgsd0Rt1bUcnVkrt5FWGfnXYF0rlQtG9yBFVjWsoIRwoXJKeFWoAleMcaYzIkgVtd7to01VLIuOKXOqn4nObwbTydbeyJxQgSmOAq_2As7-nMAHuTZeQ9-rAewU380Yy3KBcx7RFzu0VfFpZmhsVNRbXJ5vv4ZjKopIpUeoFgaI4e0AjYnmGb84wsdVx77QRx1ezxwiE-B3aNXkvVyuvvwH-_nf2avvc_blAduB6kPnbT8FYwc_B_MdqGNbegfNXWkIltupuu0QuZ0quZ-q6PbssKx3TrdjRP8AgIEcBQ</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>McAllister, David A</creator><creator>Hughes, Katherine A</creator><creator>Lone, Nazir</creator><creator>Mills, Nicholas L</creator><creator>Sattar, Naveed</creator><creator>McKnight, John</creator><creator>Wild, Sarah H</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISN</scope><scope>ISR</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>CZK</scope></search><sort><creationdate>20140801</creationdate><title>Stress hyperglycaemia in hospitalised patients and their 3-year risk of diabetes: a Scottish retrospective cohort study</title><author>McAllister, David A ; Hughes, Katherine A ; Lone, Nazir ; Mills, Nicholas L ; Sattar, Naveed ; McKnight, John ; Wild, Sarah H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c736t-948298880ea4e0ff1e891d25a8347267f8bfc30991b02c34c71708651ffc78d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Glucose - analysis</topic><topic>Cohort Studies</topic><topic>Collaboration</topic><topic>Complications and side effects</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - etiology</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Female</topic><topic>Glucose</topic><topic>Hospital care</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hyperglycemia - blood</topic><topic>Hyperglycemia - epidemiology</topic><topic>Hyperglycemia - etiology</topic><topic>Hyperglycemia - mortality</topic><topic>Illnesses</topic><topic>Lifestyles</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patient admissions</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Scotland - epidemiology</topic><topic>Sex Factors</topic><topic>Socioeconomic Factors</topic><topic>Statistics</topic><topic>Studies</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McAllister, David A</creatorcontrib><creatorcontrib>Hughes, Katherine A</creatorcontrib><creatorcontrib>Lone, Nazir</creatorcontrib><creatorcontrib>Mills, Nicholas L</creatorcontrib><creatorcontrib>Sattar, Naveed</creatorcontrib><creatorcontrib>McKnight, John</creatorcontrib><creatorcontrib>Wild, Sarah H</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McAllister, David A</au><au>Hughes, Katherine A</au><au>Lone, Nazir</au><au>Mills, Nicholas L</au><au>Sattar, Naveed</au><au>McKnight, John</au><au>Wild, Sarah H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stress hyperglycaemia in hospitalised patients and their 3-year risk of diabetes: a Scottish retrospective cohort study</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>11</volume><issue>8</issue><spage>e1001708</spage><epage>e1001708</epage><pages>e1001708-e1001708</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Hyperglycaemia during hospital admission is common in patients who are not known to have diabetes and is associated with adverse outcomes. The risk of subsequently developing type 2 diabetes, however, is not known. We linked a national database of hospital admissions with a national register of diabetes to describe the association between admission glucose and the risk of subsequently developing type 2 diabetes.
In a retrospective cohort study, patients aged 30 years or older with an emergency admission to hospital between 2004 and 2008 were included. Prevalent and incident diabetes were identified through the Scottish Care Information (SCI)-Diabetes Collaboration national registry. Patients diagnosed prior to or up to 30 days after hospitalisation were defined as prevalent diabetes and were excluded. The predicted risk of developing incident type 2 diabetes during the 3 years following hospital discharge by admission glucose, age, and sex was obtained from logistic regression models. We performed separate analyses for patients aged 40 and older, and patients aged 30 to 39 years. Glucose was measured in 86,634 (71.0%) patients aged 40 and older on admission to hospital. The 3-year risk of developing type 2 diabetes was 2.3% (1,952/86,512) overall, was <1% for a glucose ≤ 5 mmol/l, and increased to approximately 15% at 15 mmol/l. The risks at 7 mmol/l and 11.1 mmol/l were 2.6% (95% CI 2.5-2.7) and 9.9% (95% CI 9.2-10.6), respectively, with one in four (21,828/86,512) and one in 40 (1,798/86,512) patients having glucose levels above each of these cut-points. For patients aged 30-39, the risks at 7 mmol/l and 11.1 mmol/l were 1.0% (95% CI 0.8-1.3) and 7.8% (95% CI 5.7-10.7), respectively, with one in eight (1,588/11,875) and one in 100 (120/11,875) having glucose levels above each of these cut-points. The risk of diabetes was also associated with age, sex, and socio-economic deprivation, but not with specialty (medical versus surgical), raised white cell count, or co-morbidity. Similar results were obtained for pre-specified sub-groups admitted with myocardial infarction, chronic obstructive pulmonary disease, and stroke. There were 25,193 deaths (85.8 per 1,000 person-years) over 297,122 person-years, of which 2,406 (8.1 per 1,000 person-years) were attributed to vascular disease. Patients with glucose levels of 11.1 to 15 mmol/l and >15 mmol/l had higher mortality than patients with a glucose of <6.1 mmol/l (hazard ratio 1.54; 95% CI 1.42-1.68 and 2.50; 95% CI 2.14-2.95, respectively) in models adjusting for age and sex. Limitations of our study include that we did not have data on ethnicity or body mass index, which may have improved prediction and the results have not been validated in non-white populations or populations outside of Scotland.
Plasma glucose measured during an emergency hospital admission predicts subsequent risk of developing type 2 diabetes. Mortality was also 1.5-fold higher in patients with elevated glucose levels. Our findings can be used to inform patients of their long-term risk of type 2 diabetes, and to target lifestyle advice to those patients at highest risk. Please see later in the article for the Editors' Summary.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25136809</pmid><doi>10.1371/journal.pmed.1001708</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2014-08, Vol.11 (8), p.e1001708-e1001708 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_1685382854 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Age Age Factors Aged Aged, 80 and over Blood Glucose - analysis Cohort Studies Collaboration Complications and side effects Diabetes Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology Diabetes Mellitus, Type 2 - mortality Female Glucose Hospital care Hospitalization Hospitals Humans Hyperglycemia Hyperglycemia - blood Hyperglycemia - epidemiology Hyperglycemia - etiology Hyperglycemia - mortality Illnesses Lifestyles Logistic Models Male Medical research Medicine and Health Sciences Middle Aged Mortality Patient admissions Retrospective Studies Risk Risk factors Scotland - epidemiology Sex Factors Socioeconomic Factors Statistics Studies Time Factors |
| title | Stress hyperglycaemia in hospitalised patients and their 3-year risk of diabetes: a Scottish retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T11%3A28%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Stress%20hyperglycaemia%20in%20hospitalised%20patients%20and%20their%203-year%20risk%20of%20diabetes:%20a%20Scottish%20retrospective%20cohort%20study&rft.jtitle=PLoS%20medicine&rft.au=McAllister,%20David%20A&rft.date=2014-08-01&rft.volume=11&rft.issue=8&rft.spage=e1001708&rft.epage=e1001708&rft.pages=e1001708-e1001708&rft.issn=1549-1676&rft.eissn=1549-1676&rft_id=info:doi/10.1371/journal.pmed.1001708&rft_dat=%3Cgale_plos_%3EA382807176%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1555248047&rft_id=info:pmid/25136809&rft_galeid=A382807176&rft_doaj_id=oai_doaj_org_article_82bf5631178a4317b6a60b5575c2181b&rfr_iscdi=true |