Background: The prevalence of altered glucose states are rising exponentially due to population ageing, decreased physical activity and increasing obesity levels (WHO, 2005). Altered glucose states are associated with increased morbidity and mortality and place a major financial burden on healthcare budgetary resources (Rubin et al, 1994). Hospitalisation costs, to treat the avoidable complications of diabetes, are the most significant contributor to the costs of diabetes related healthcare expenditure. This survey was undertaken to ascertain the prevalence of altered glucose states in acute, medical, hospital admissions and to estimate the cost of this care to the Irish healthcare system. Methods: A prospective survey of an unselected sample was undertaken in acute medical admissions to a Regional hospital in Ireland. Between June 1st 2005 and 17th December 2006, 1273 individuals were enrolled in this survey. Of these, 419 eligible individuals had a known or new diagnosis of type 1 or type 2 diabetes, impaired glucose tolerance or impaired fasting glucose and a history of complication or risk factor for diabetes. Findings: 34% of individuals hospitalised in this cohort had an altered glucose state. Type 2 diabetes was the most prevalent and was recorded in 21%. Impaired glucose tolerance was the principal newly diagnosed altered glucose state identified in 38% of individuals. All combined altered glucose states and type 2 diabetes alone were more prevalent in males however, a new diagnosis following screening did nor vary according to gender. Individuals with an altered glucose state were also older with new IGT becoming more prevalent with age. This was in contrast to negative OGTT results which decreased with increased age. The cost of treating individuals in this cohort was estimated at €501,124 or €3,458,144 million, when applied to the total population of acute medical patients, admitted to this regional hospital. Conclusions: This study identified previously unavailable hospital admission data, for individuals requiring acute medical care in Ireland. In this study 34% of all acute medical hospital admissions had an altered glucose state. In addition, a significant number of individuals had a previously undiagnosed altered glucose state on admission. This study confirmed the significant cost of hospitalisation care, for altered glucose states in association with microvascular and macrovascular complications and the impact of this on the healthcare system.
|Publication status||Submitted - 2009|