Clinical Presentation

Typical Signs and Symptoms:

• Hyperglycemia: Elevated blood glucose levels, often exceeding 180 mg/dL.
• Polyuria: Frequent urination, a body’s way to get rid of excess sugar.
• Polydipsia: Increased thirst, usually alongside frequent urination.
• Blurred Vision: High levels of glucose pulling fluid from tissues, including the eyes.
• Fatigue: Lack of energy due to the inability of cells to receive glucose.

Risk Factors:

• Pre-existing Diabetes: Both Type 1 and Type 2.
• Stress: Due to illness or surgery.
• Medications: Steroids, antipsychotics, and certain antihypertensives.
• Nutritional Factors: Parenteral or enteral feeding without adequate insulin coverage.

Demographics:

Hyperglycemia in hospitals affects a broad range of patients, but the risk is notably higher in older adults and those with a history of diabetes. It also commonly occurs in patients undergoing complex surgeries or those with severe illnesses involving multiple organ systems.

Common Pitfalls and Misdiagnoses:

The symptoms of hyperglycemia can be subtle and may be overshadowed by the underlying conditions that necessitated the hospitalization. For instance, fatigue and altered mental status can be misattributed to the patient’s primary illness rather than being recognized as signs of hyperglycemia.

Clinical Insights:

Managing hyperglycemia is not just about treating high blood sugar levels; it’s about a comprehensive approach that involves accurate diagnosis, identifying the underlying causes, and tailoring treatment accordingly. Clinical pharmacists play a vital role in this, especially in selecting appropriate therapies and monitoring for potential drug interactions and side effects.