A hospitalized patient not diagnosed as diabetic may develop hyperglycemia. The significance of this finding needs to be investigated.
Differential diagnosis:
(1) diabetes that had not been previously recognized
(2) prediabetes
(3) hospital-related hyperglycemia
Factors that may contribute to hyperglycemia:
(1) infusions of dextrose-containing fluids
(2) parenteral nutrition
(3) discontinuing of anti-hyperglyemic medications
(4) administration of hyperglycemia-inducing medications (vasopressors, glucocorticoids)
(5) physiologic stress
(6) transient insulin resistance
Hyperglycemia in the hospital should be monitored and controlled if necessary.
If a blood sample from admission is available, then consider testing for hemoglobin A1c.
The patient should be evaluated after discharge from the hospital, recovery from acute illness and discontinuation of factors that may be contributing to the hyperglycemia.
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