Acute Hyperglycemia During Hospitalization, Nutritional Support, and Longer-Term Cardiovascular Outcomes: a Nationwide Real-World Data Cohort Study: GI Signals

Nutrition retrospective · n=5,174,261 · Sep 9, 2026 · Am J Clin Nutrition · IF 6.5

Acute Hyperglycemia During Hospitalization, Nutritional Support, and Longer-Term Cardiovascular Outcomes: a Nationwide Real-World Data Cohort Study.

New evidenceenteral nutritionparenteral nutritionepidemiology

Clinical takeawayIn non-diabetic adults without baseline cardiovascular disease, risk-stratify post-discharge patients based on acute hospitalization hyperglycemia. Counsel patients with glucose >180 mg/dL during admission about elevated long-term cardiovascular risk and consider intensified cardiovascular risk factor management (BP control, lipid management, smoking cessation, weight/glucose targets). Effect is more pronounced in patients who received parenteral or enteral nutrition. This observational study identifies an association but does not establish causality or demonstrate that acute glucose control itself reduces subsequent cardiovascular outcomes.

What it foundAcute hyperglycemia (blood glucose >180 mg/dL) during hospitalization, present in 26.8% of non-diabetic patients, associated with a 1.82-fold increased risk of composite cardiovascular events over median 2.3 years post-discharge (95% CI 1.80-1.84); risk rose to 2.11-fold with parenteral nutrition and 1.95-fold with enteral nutrition.

ContextPrior evidence established acute hyperglycemia as a marker of acute illness severity; this extends that finding to show persistent long-term cardiovascular consequences in non-diabetic patients years after discharge. Novel is the interaction with nutritional support-effect strongest with parenteral nutrition (2.11-fold), intermediate with enteral (1.95-fold), and weaker without nutritional support (1.35-fold)-suggesting nutritional route or severity of illness modifies the association. The mechanism remains unexplained; unmeasured confounding (unmeasured illness severity, complications, or metabolic derangement) cannot be ruled out.

Emergingsuggested applicable standard· American Diabetes Association Professional Practice Committee, "6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026," Diabetes Care 2026;49(Supplement_1):S132-S149

Decision at stakemanaging acute hyperglycemia in non-diabetic hospitalized patients receiving nutritional support

No single passage of this standard matched the paper closely enough to quote, so none is shown. The standard is cited above.

Our full summary of this standard

Manage diabetes in GI/hepatology patients by individualizing the A1c target to the population, in cirrhosis, A1c is unreliable because altered red blood cell turnover typically underestimates glycemia, so set glycemic goals using blood glucose monitoring and/or CGM rather than a fixed A1c cutoff, and in diabetic gastroparesis individualize the target rather than applying a universal cutoff; ≤7% pre-bariatric, <6.5% pre-conception, while screening all T2DM for MASLD with FIB-4, screening T1DM for concurrent celiac disease, and screening for diabetic gastroparesis when chronic nausea, early satiety, or postprandial fullness are present. Evaluate new-onset DM after age 50 without obesity for a pancreatic cancer differential, and coordinate peri-procedural medication holds and multidisciplinary endocrinology involvement.

American Diabetes Association Professional Practice Committee, "6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026," Diabetes Care 2026;49(Supplement_1):S132-S149 · reviewed 2026-07-23 ↗

Santos MP … Ley SH · American Journal of Clinical Nutrition · IF 6.5 · PubMed ↗Permalink