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All admissions should have HbA1c test

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All inpatients should have their blood glucose levels checked on admission, regardless of whether they are known to have diabetes, according to new US clinical practice guidelines.

The “Management of Hyperglycemia in Hospitalised Patients in Non-Critical Care Setting” guidelines have been developed by the Endocrine Society following evidence suggesting that 32-38% of patients in community hospitals suffer from hyperglycaemia.

Studies that observed blood glucose levels in patients during their stay in community hospitals showed that patients even without diabetes should have their blood sugar levels monitored as prevalence of hyperglycaemia remains high.

The guideline authors said: “All patients, independent of a prior diagnosis of diabetes, should have their blood glucose levels tested upon admission to a hospital.

“Hyperglycaemia is associated with prolonged hospital stay, increased incidence of infections and death in non-critically ill hospitalised patients.”

The guidelines also recommend that patients with type 1 and type 2 diabetes receive insulin intravenously during surgery and be placed on subcutaneous insulin at least one to two hours before this infusion is stopped.

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