This was a prospective, observational cross-sectional study conducted at a tertiary care private hospital in India. The study was designed to comprehensively evaluate the prevalence, management strategies, and clinical outcomes of in-hospital hyperglycemia among adult inpatients. The study also explored the associations of metabolic biomarkers-fetuin-A and fibroblast growth factor-21 (FGF-21) as well as sarcopenic obesity and nutritional factors with clinical outcomes, including length of hospital stay (LOS), complications, and mortality. Institutional Ethics Committee approval was obtained prior to study initiation, and written informed consent was secured from all participants

Inclusion Criteria:

• Adult patients aged ≥18 years.
• Patients with known or newly diagnosed type 2 diabetes mellitus (T2DM) or those presenting with hyperglycemia (random blood glucose ≥140 mg/dL) during hospitalization.
• Both medical and surgical inpatients admitted for ≥24 hours

Exclusion Criteria:

• Pregnant or lactating women.
• Patients with type 1 diabetes mellitus or other specific types of diabetes (e.g., pancreatogenic, drug-induced).
• Patients with chronic liver disease unrelated to diabetes or hepatic dysfunction secondary to viral hepatitis, autoimmune hepatitis, or alcohol abuse.
• Critically ill patients requiring palliative care or those with advanced malignancy

Newly diagnosed type 2 diabetes mellitus (T2DM) or those presenting with hyperglycemia