The burden of diagnosed and undiagnosed diabetes in Native Hawaiian and Asian American hospitalized patients

•38% of Native Hawaiian, 34% of Japanese, 33% of Filipino, 23% of Chinese and 19% of White inpatients had diagnosed diabetes.•3% Native Hawaiian, 3% Japanese, 4% Filipino, 4% Chinese and 4% White inpatients had potentially undiagnosed diabetes.•Few potentially undiagnosed diabetes cases were found. Prospective methods are recommended.•Potentially undiagnosed diabetes was associated with a longer hospital stay and higher mortality.•Inpatient diabetes screening with HbA1c is suggested, which should be evaluated prospectively for improved outcomes.

AimsLittle is known about diabetes in hospitalized Native Hawaiians and Asian Americans. We determined the burden of diabetes (both diagnosed and undiagnosed) among hospitalized Native Hawaiian, Asian (Filipino, Chinese, Japanese), and White patients.MethodsDiagnosed diabetes was determined from discharge data from a major medical center in Hawai‘i during 2007–2008. Potentially undiagnosed diabetes was determined by Hemoglobin A1c ≥ 6.5% or glucose ≥ 200 mg/dl values for those without diagnosed diabetes. Multivariable log-binomial models predicted diabetes (potentially undiagnosed and diagnosed, separately) controlling for socio-demographic factors.ResultsOf 17,828 hospitalized patients, 3.4% had potentially undiagnosed diabetes and 30.5% had diagnosed diabetes. In multivariable models compared to Whites, Native Hawaiian and all Asian subgroups had significantly higher percentages of diagnosed diabetes, but not of potentially undiagnosed diabetes. Potentially undiagnosed diabetes was associated with significantly more hospitalizations during the study period compared to both those without diabetes and those with diagnosed diabetes. In all racial/ethnic groups, those with potentially undiagnosed diabetes also had the longest length of stay and were more likely to die during the hospitalization.ConclusionsHospitalized Native Hawaiians (41%) and Asian subgroups had significantly higher overall diabetes burdens compared to Whites (23%). Potentially undiagnosed diabetes was associated with poor outcomes. Hospitalized patients, irrespective of race/ethnicity, may require more effective inpatient identification and management of previously undiagnosed diabetes to improve clinical outcomes.