Risk factors at admission of in-hospital dysglycemia, mortality, and readmissions in patients with type 2 diabetes and pneumonia

In-hospital dysglycemia is associated with adverse outcomes. Identifying patients at risk of in-hospital dysglycemia early on admission may improve patient outcomes. We analysed 117 inpatients admitted with pneumonia and type 2 diabetes monitored by continuous glucose monitoring. We assessed potential risk factors for in-hospital dysglycemia and adverse clinical outcomes. Time in range (3.9–10.0 mmol/l) decreased by 2.9 %-points [95 % CI 0.7–5.0] per 5 mmol/mol [2.6 %] increase in admission haemoglobin A1c, 16.2 %-points if admission diabetes therapy included insulin therapy [95 % CI 2.9–29.5], and 2.4 %-points [95 % CI 0.3–4.6] per increase in the Charlson Comorbidity Index (CCI) (integer, as a measure of severity and amount of comorbidities). Thirty-day readmission rate increased with an IRR of 1.24 [95 % CI 1.06–1.45] per increase in CCI. In-hospital mortality risk increased with an OR of 1.41 [95 % CI 1.07–1.87] per increase in Early Warning Score (EWS) (integer, as a measure of acute illness) at admission. Dysglycemia among hospitalised patients with pneumonia and type 2 diabetes was associated with high haemoglobin A1c, insulin treatment before admission, and the amount and severity of comorbidities (i.e., CCI). Thirty-day readmission rate increased with high CCI. The risk of in-hospital mortality increased with the degree of acute illness (i.e., high EWS) at admission. Clinical outcomes were independent of chronic glycemic status, i.e. HbA1c, and in-hospital glycemic status. [Display omitted] •Knowledge of risk factors for in-hospital dysglycemia detected early at admission is sparse.•High HbA1c, insulin treatment before admission, and many comorbidities are risk factors at admission for dysglycemia during hospitalisation.•Early identification of patients at risk of in-hospital dysglycemia could initiate interventions and improve patient outcomes.