Using a Diabetes Risk Score to Identify Patients without Diabetes at Risk for New Hyperglycemia in the Hospital.

OBJECTIVE To assess the value of a validated diabetes risk test, the Cambridge Risk Score (CRS), to identify patients admitted to the hospital without diabetes at risk for new hyperglycemia (NH) METHODS: This was a retrospective cross-sectional study that included adults admitted to the Hospital in a 4-year period. Patients with no diabetes diagnosis, and on no antidiabetics were included. The Cambridge risk score was calculated for each individual and patients with available HbA1c were also investigated in a second analysis. Multivariate regression analyses were performed to assess the association between CRS, HbA1c, and risk of NH. RESULTS A total of 19,830 subjects comprised the sample, of which 38% were found to have developed NH defined as blood glucose ≥ 140mg/dL. After accounting for covariates, CRS was significantly associated with NH [ OR 1.19 (1.16 ,1.22), P = <0.001]. Only 17% of patients had HbA1c values within 6 months of admission. Compared to patients without diabetes, patients with prediabetes based on their HbA1c [OR 1.59 (1.37 ,1.86), P = <0.001], and patients with undiagnosed diabetes [OR 5.95 (3.50 ,10.65) P = <0.001] were also significantly more likely to have NH. CONCLUSION Results of this study show that the CRS and HbA1c were significantly associated with the risk of developing NH in inpatient adults without diabetes. Given that HbA1c was missing in most medical records of hospitalized patients without diabetes, the CRS could be a useful tool for early identification and management of NH possibly leading to better outcomes.