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Clinical Summary

Hyperglycaemia detected in ED is an opportunity for intervention

Takeaway

  • In this study at an Australian emergency department (ED), 1 in 20 patients presented with hyperglycaemia and without previously recognised diabetes.
  • They received dismally low rates of appropriate follow-up.
  • Authors call for routine screening and better management.

Why this matters

  • Failure to respond to high glucose measurements represents a lost opportunity.

Key results

  • Prevalence of hyperglycaemia in patients without previously recognised diabetes: 5.2%.
  • Rates in nested cohort of:
    • Follow-up HbA1c testing: 7.5%.
    • Adequate glucose monitoring: 9.5%.
    • Appropriate hyperglycaemia treatment: 6.5%.
    • Documentation of follow-up plan: 2%.

Study design

  • Retrospective cross-sectional study of adults presenting to a Melbourne ED in a recent 6-month period with hyperglycaemia and no previous diabetes diagnosis (n=1178).
  • The hospital had just instituted universal random glucose screening as part of all ED plasma testing.
  • Authors assessed appropriate treatment and follow-up rates within a nested cohort (n=200).
  • Outcomes: rate of hyperglycaemia and of appropriate medical response.
  • Funding: None disclosed.

Limitations

  • Small single-centre study.

References


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