Diabetes in the ED: Opportunities for Improvement

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According to 2011 estimates, about 79 million Americans had prediabetes and another 7 million were undiagnosed. By 2025, it is estimated that the number of people with prediabetes will increase to 472 million globally. For many of these patients, the ED may be their only source of medical care or interaction with a healthcare provider. The ED may be an ideal place to identify people with elevated random blood glucose levels, inform them of these findings, and refer them for follow-up.

For a study, researchers aimed to determine the incidence of elevated blood glucose levels and the disposition of these individuals using retrospective data from two EDs. The authors identified 106 patients with random blood glucose levels of 150 mg/dL or higher who did not have a prior diagnosis of diabetes over a 9-day period. The average glucose level was 181.53 mg/dL for these individuals. About 42% of these patients were discharged, but only 1 of these patients was informed about their elevated blood glucose levels and referred for follow-up.

The findings highlight the fact that opportunities exist to better address this group of patients who are being missed. The study team noted that failing to inform and provide referrals reduces patients’ abilities to make relevant lifestyle changes to help prevent or delay the progression of prediabetes to type 2 diabetes.

Source: Journal of Emergency Nursing, July 2014.

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