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Type 2 Diabetes Prevention and Management: An Update on Emerging Findings (Poster Theater Flash Session 10)

(PTFS10-07-25) Association Between Acute Hyperglycemia During Hospitalization and Longer-Term Cardiovascular Risk Influenced by Nutritional Support: A Nationwide Cohort Study

Monday, June 2, 2025
12:20 PM – 12:24 PM ET
Location: South Hall B (The Hub) - Poster Theater / Poster Board Number PT-6

    Presenting Author(s)

  • MS

    Maria P. Santos, MS

    PhD Candidate
    Tulane University
    Sunny Isle Beach, Louisiana, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • SL

    Sylvia H. Ley, PhD, RD (she/her/hers)

    Assistant Professor
    Tulane University
    New Orleans, Louisiana, United States

Objectives: To assess whether acute hyperglycemia in hospitalized patients without pre-existing diabetes is associated with an increased risk of long-term cardiovascular (CV) events, and whether nutritional support modalities modify this relationship.

Methods: Using the National Clinical Cohort Collaborative (N3C), we analyzed 5,174,261 U.S. hospital admissions (March 1, 2020–March 1, 2022). Acute hyperglycemia was defined as blood glucose levels exceeding 140 to 180 mg/dL in patients without a pre-existing diabetes diagnosis. The primary outcome was a composite of physician-diagnosed CV events (cerebrovascular disorders, dysrhythmias, inflammatory heart disease, ischemic heart disease, heart failure, thrombotic disorders) occurring >30 days post-discharge. The median follow-up was 2.3 years (IQR:1.8-3.4 years). Cox proportional hazard ratio (HR) models were assessed, adjusted for age, sex, race/ethnicity, hypertension, obesity, coronary artery disease, diabetes, chronic kidney disease, chronic lung disease, and cardiovascular medication use.

Results: We included 5,174,261 patients (mean [SD] age, 55 [21] years; 40.5% male; 67.2% white). During hospitalization, 1,390,281 (26.8%) had acute hyperglycemia. The unadjusted HR for the association between hyperglycemia and CV events was 2.03 (95% CI: 2.01–2.05), and after adjustment the HR was 1.82 (95% CI: 1.80–1.84). Among parenteral feeding recipients, acute hyperglycemia was associated with CV events with an adjusted HR of 2.11 (95% CI 2.06–2.16; p-interaction < 0.01 vs no nutritional support). Among enteral feeding recipients, acute hyperglycemia was associated with CV events with an adjusted HR of 1.95 (95% CI 1.92–1.98; p-interaction=0.046 vs no nutritional support). Among patients who did not receive nutritional support, acute hyperglycemia was associated with CV events with an adjusted HR of 1.35 (95% CI 1.32–1.38; p-interaction < 0.01 vs no nutritional support).

Conclusions: Hospitalization-associated hyperglycemia is associated with a higher long-term CV risk. This risk was notably amplified among patients who received parenteral or enteral feeding during hospitalization, highlighting the potential need for integrated glycemic and nutritional management to mitigate post-discharge CV complications.

Funding Sources: NHLBI