Factors Influencing Inhospital Glycemic Control in Noncritically Ill Adult Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study from a Tertiary Care Hospital in South India

Abstract Introduction: Hyperglycemia during hospitalization is associated with increased morbidity and mortality among patients with diabetes. This study aims to identify factors associated with suboptimal glycemic control (SGC) among inpatients with diabetes and to compare glycemic control between medical and surgical patients. Materials and Methods: We conducted a cross-sectional study of 200 noncritically ill patients with type 2 diabetes hospitalized for at least 3 days at a tertiary care hospital in South India. Data on demographics, comorbidities, blood glucose levels, hemoglobin A1C (HbA1c), medications, and hospital events were analyzed. SGC was defined as <70% of point-of-care glucose readings falling within the 80–180 mg/dl range. Factors influencing SGC were identified using multiple logistic regression. Results: Of 200 patients, 159 (79.5%) achieved optimal glycemic control (OGC). SGC was associated with HbA1c >9% (adjusted odds ratio [AOR] 10.99, confidence interval [CI] 1.11, 109.26), higher admission glucose levels (AOR 1.01, CI 1, 1.01), and daily insulin titration. OGC was associated with endocrinologist intervention, admission to surgical specialities, inhospital procedures, and nil per os periods. However, these patients had a higher risk of hypoglycemia (AOR 0.12, CI 0.02, 0.56) ( P < 0.05). Conclusion: Most hospitalized, noncritically ill patients achieved glycemic control with insulin and oral medications. HbA1c >9% and high admission glucose were associated with SGC, whereas optimal control was more common among patients admitted to surgical specialities with endocrinologist intervention. Targeted, multipronged interventions are needed to improve inhospital glycemic control without increasing the risk of hypoglycaemia.