The High Burden of In-Hospital Diabetes Mellitus at A Tertiary Care Hospital in Sri Lanka; A Case Control Study

Background: Sri Lanka has a very high prevalence of diabetes with poorly organized diabetes care and limited resources for in-patient management. At present, 10.3% of the population is diabetic. Aim: The aim of this study was to define the reasons for admission of diabetic patients to a tertiary care general medical unit, to calculate the point prevalence of diabetes related admissions, the mean duration of hospital stay and assess their in-hospital glycaemic control. Design: A case-control study. Methods: Data of 300 consecutive diabetic and non-diabetic admissions to the professorial medical unit at Teaching Hospital Peradeniya were studied between 30th May and 30th August 2011. Results: The in-hospital point prevalence of diabetes was 40.4%. One quarter of diabetes related admissions were for control of hyperglycaemia. Twenty two percent were for acute coronary syndromes and another 16% for treatment of infections. Mean duration of hospital stay was 6.6 days for diabetic patients and 4.6 days for nondiabetic patients (P<0.01). The mean hospital stay of patients presenting with hypergycaemia was 6 days. The mean fasting plasma glucose on admission and discharge in the diabetes group were 10.67 and 8.3 mmol/L respectively. Over 98% of diabetic patients had at least one in-hospital glucose value that exceeded 10 mmol/L. Conclusion: A quarter of diabetes related admissions were for control of hyperglycaemia. Presence of diabetes mellitus significantly delayed the discharge of medical admissions. In-hospital glycaemic control of patients was generally poor. An effective diabetes outreach service needs to be initiated urgently to reduce diabetes related admissions.