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Introduction <p>Hyperglycemia is a frequent metabolic abnormality in hospitalized patients and is associated with increased risk of complications, intensive care requirement, and mortality. In India, the rising burden of diabetes and undiagnosed dysglycemia further amplifies this concern. However, prospective data linking glycemic status with metabolic parameters and inpatient outcomes in the Indian setting remain limited. This study aimed to evaluate the prevalence of in-hospital hyperglycemia and examine its association with clinical outcomes in a tertiary-care hospital.</p> Methods <p>In this 12-month prospective observational cohort study conducted at a tertiary care hospital, 362 consecutive adult inpatients were prospectively enrolled and screened for glycemic abnormalities during hospitalization; 308 (85.1%) had confirmed hyperglycemia and 54 (14.9%) were normoglycaemic. Detailed anthropometry, glycemic indices, and metabolic biomarkers including Fetuin-A, FGF-21, HOMA-IR, hs-CRP, and liver fibrosis scores were measured. Sarcopenia and sarcopenic obesity were assessed. Outcomes included infections, hypoglycemia, AKI, length of stay (LOS), ICU transfer, and in-hospital mortality.</p> Results <p>Hyperglycemia was highly prevalent 308 (85.1%), including stress hyperglycemia 80 (22.1%) and newly diagnosed diabetes 50 (13.8%). Patients demonstrated marked glycemic derangement (mean daily glucose 184 ± 39&#xa0;mg/dL; peak 312 ± 85&#xa0;mg/dL). Infections 96 (26.5%), AKI 54 (14.9%), and mortality 14 (3.9%) were common. Higher admission glucose quartiles showed a dose-response rise in infections (12%-42%), ICU transfers (3%-22%), and mortality (0%-10%) (<i>p</i> &lt; 0.001). Obesity and sarcopenic obesity were strongly associated with complications and mortality. ICU patients had significantly higher glycemic, inflammatory, and fibrosis markers. Basal-bolus therapy was associated with fewer infections, shorter LOS, and lower mortality than sliding-scale regimens.</p> Conclusion <p>In-hospital hyperglycemia is pervasive and strongly predicts morbidity and mortality, amplified by obesity, sarcopenic obesity, inflammation, and metabolic dysfunction. These findings highlight the need for structured inpatient glycemic protocols and integrated metabolic risk stratification to improve patient outcomes.</p> Clinical Trial Number <p>NCT07626775</p>

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Clinical Insights and Outcomes in Hospitalized Adults with Hyperglycemia: A Prospective Study from an Indian Tertiary-care Center

  • 期刊论文

  • 发表日期：

    2026年7月16日

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  • Surender,
  • Vyas M. Shingatgeri,
  • Pushpender Khatana,
  • Mohammad Zeeshan Najm,
  • Sunil Kumar Mishra,
  • Mohammad Shafi Kuchay

摘要

Introduction

Hyperglycemia is a frequent metabolic abnormality in hospitalized patients and is associated with increased risk of complications, intensive care requirement, and mortality. In India, the rising burden of diabetes and undiagnosed dysglycemia further amplifies this concern. However, prospective data linking glycemic status with metabolic parameters and inpatient outcomes in the Indian setting remain limited. This study aimed to evaluate the prevalence of in-hospital hyperglycemia and examine its association with clinical outcomes in a tertiary-care hospital.

Methods

In this 12-month prospective observational cohort study conducted at a tertiary care hospital, 362 consecutive adult inpatients were prospectively enrolled and screened for glycemic abnormalities during hospitalization; 308 (85.1%) had confirmed hyperglycemia and 54 (14.9%) were normoglycaemic. Detailed anthropometry, glycemic indices, and metabolic biomarkers including Fetuin-A, FGF-21, HOMA-IR, hs-CRP, and liver fibrosis scores were measured. Sarcopenia and sarcopenic obesity were assessed. Outcomes included infections, hypoglycemia, AKI, length of stay (LOS), ICU transfer, and in-hospital mortality.

Results

Hyperglycemia was highly prevalent 308 (85.1%), including stress hyperglycemia 80 (22.1%) and newly diagnosed diabetes 50 (13.8%). Patients demonstrated marked glycemic derangement (mean daily glucose 184 ± 39 mg/dL; peak 312 ± 85 mg/dL). Infections 96 (26.5%), AKI 54 (14.9%), and mortality 14 (3.9%) were common. Higher admission glucose quartiles showed a dose-response rise in infections (12%-42%), ICU transfers (3%-22%), and mortality (0%-10%) (p < 0.001). Obesity and sarcopenic obesity were strongly associated with complications and mortality. ICU patients had significantly higher glycemic, inflammatory, and fibrosis markers. Basal-bolus therapy was associated with fewer infections, shorter LOS, and lower mortality than sliding-scale regimens.

Conclusion

In-hospital hyperglycemia is pervasive and strongly predicts morbidity and mortality, amplified by obesity, sarcopenic obesity, inflammation, and metabolic dysfunction. These findings highlight the need for structured inpatient glycemic protocols and integrated metabolic risk stratification to improve patient outcomes.

Clinical Trial Number

NCT07626775