Inpatient diabetes care requires adequate support, not just HbA1c screening

Matthew JL Hare and Jonathan E Shaw
Med J Aust 2019; 211 (10): . || doi: 10.5694/mja2.50391
Published online: 18 November 2019

Routine admission screening of patients is desirable, but financial and personnel support for diabetes services is essential

Hyperglycaemia is common among hospitalised patients and is associated with increased complication rates, longer admissions, more frequent re‐admissions, and higher mortality.1,2,3,4 Its detection can also be an opportunity for identifying undiagnosed diabetes. Trials have confirmed that improving inpatient glycaemic control reduces complication rates,2 and guidelines recommend that the blood glucose levels of all patients be checked on admission; if hyperglycaemia is detected, glycated haemoglobin (HbA1c) should also be measured.2,5 HbA1c assessment can help differentiate stress‐induced hyperglycaemia from undiagnosed diabetes, and also aids evaluation of treatment adequacy in people with known diabetes. Nevertheless, the identification of undiagnosed diabetes in hospitalised patients is sub‐optimal.

  • Matthew JL Hare1,2
  • Jonathan E Shaw3,4

  • 1 Menzies School of Health Research, Darwin, NT
  • 2 Royal Darwin Hospital, Darwin, NT
  • 3 Baker IDI Heart and Diabetes Institute, Melbourne, VIC
  • 4 Monash University, Melbourne, VIC



Jonathan Shaw is supported by a National Health and Medical Research Council (NHMRC) Senior Research Fellowship. This work was partly supported by the Victorian Operational Infrastructure Support Program. Matthew Hare is supported by an NHMRC Postgraduate Scholarship, the Australian Academy of Science Douglas and Lola Douglas Scholarship, and the NHMRC/Diabetes Australia Postgraduate Award.

Competing interests:

Jonathan Shaw has received honoraria for lectures and consultancies from Astra Zeneca, Eli Lilly, Mylan, Novo Nordisk, Sanofi, Merck Sharp and Dohme, Abbott, and Boehringer Ingelheim.


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