Do Adult Patients With Type 1 or 2 Diabetes Who Present to the Emergency Department With Hyperglycemia Have Improved Outcomes if They Have Access to Specialized Diabetes Care?

Yan, Justin; Liu, Selina L.; Aarsen, K. Van; Columbus, M.; Spaic, Tamara

doi:10.1016/j.jcjd.2020.05.011

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…The 30-day hospitalization rate was 229/24 (10.4%), which was similar to previous studies [10]. There are studies showing that reducing the frequency of recurrent emergency department admissions can be reduced with accessible special diabetes follow-up programs, and it would be bene cial to include all diabetic patients discharged from the emergency department in such family medicine or endocrinology programs [11].…”

Section: Discussionsupporting

confidence: 86%

Determinant of the Frequency of Short-Term Undesirable Events in Diabetes Discharged from the Emergency Department

Günsoy

Selman²,

Duyan³

et al. 2023

SN Compr. Clin. Med.

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ObjectivesIn our study, we aimed to reveal the frequency and determinants of adverse events in patients with diabetes mellitus, who presented to the emergency department for any reason, had uncomplicated hyperglycemia, but were decided to be treated as an outpatient. ResultsAs the patient group with a plasma glucose level of 200 mg/dl and above and normoglycemic diabetic patients were evaluated, no signi cant difference was found in terms of re-admission to the emergency department and the frequency of hospitalization. (Respectively, within seven days p=0.738, 0.805, within thirty days p=0.130, 0.697). In the patient group with plasma glucose level of 200 mg/dl and above, waiting times in the emergency department (p= 0.012) and average uid replacement were higher (p=0.002). As the factors affecting re-admission were evaluated, it was found signi cant that the patient had insulin-dependent diabetes. (Within in seven days OR:2.20, %95 GA 1,.26-3.84, p = 0.005; within thirty days OR:2.48, %95 GA 1.39-4.41, p = 0.002). Other factors such as gender, age, admission glucose level and diabetes type were not found to be effective. ConclusionsThe high blood glucose level of diabetic non-complicated hyperglycemia cases admitted to the emergency department was not found to have an effect on recurrent admissions and hospitalizations for any reason in the rst seven and thirty days. Treatment and follow-up planning should be done carefully in insulin-dependent diabetic patients with a high probability of re-admission and hospitalization in this group

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Section: Discussionsupporting

confidence: 86%

Determinant of the Frequency of Short-Term Undesirable Events in Diabetes Discharged from the Emergency Department

Günsoy

Selman²,

Duyan³

et al. 2023

SN Compr. Clin. Med.

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“…A retrospective study in Ontario revealed that patients presenting with hyperglycemia in the emergency department who were then referred to specialized diabetes care had better short-term outcomes. 39 Each encounter should thus be seen as an opportunity to evaluate risk factors of worsening disease and suboptimal disease management and to intervene with appropriate coordinated services where required. This includes opportunities to screen not only for risk factors for kidney disease but also for other related conditions (eg, cardiovascular disease and neuropathy).…”

Section: Pitfalls Along the Journey Of Diabetic Nephropathymentioning

confidence: 99%

Bridging Gaps in Diabetic Nephropathy Care: A Narrative Review Guided by the Lived Experiences of Patient Partners

Beaubien-Souligny

Leclerc

Ramzanali

et al. 2022

Can J Kidney Health Dis

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Purpose of review: Diabetes affects almost a 10th of the Canadian population, and diabetic nephropathy is one of its main complications. It remains a leading cause of kidney failure despite the availability of effective treatments. Sources of information: The sources of information are iterative discussions between health care professionals and patient partners and literature collected through the search of multiple databases. Methods: Major pitfalls related to optimal diabetic nephropathy care were identified through discussions between patient partners and clinician researchers. We identified underlying factors that were common between pitfalls. We then conducted a narrative review of strategies to overcome them, with a focus on Canadian initiatives. Key findings: We identified 5 pitfalls along the diabetic nephropathy trajectory, including a delay in diabetes diagnosis, suboptimal glycemic control, delay in the detection of kidney involvement, suboptimal kidney protection, and deficient management of advanced chronic kidney disease. Several innovative care models and approaches have been proposed to address these pitfalls; however, they are not consistently applied. To improve diabetic nephropathy care in Canada, we recommend focusing initiatives on improving awareness of diabetic nephropathy, improving access to timely evidence-based care, fostering inclusive patient-centered care environment, and generating new evidence that supports complex disease management. It is imperative that patients and their families are included at the center of these initiatives. Limitations: This review was limited to research published in peer-reviewed journals. We did not perform a systematic review of the literature; we included articles that were relevant to the major pitfalls identified by our patient partners. Study quality was also not formally assessed. The combination of these factors limits the scope of our conclusions.

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Predictors of 30-day recurrent emergency department visits for hyperglycemia in patients with types 1 and 2 diabetes: a population-based cohort study

Yan,

Vujcic,

et al. 2024

Can J Emerg Med

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Do Adult Patients With Type 1 or 2 Diabetes Who Present to the Emergency Department With Hyperglycemia Have Improved Outcomes if They Have Access to Specialized Diabetes Care?

Cited by 6 publications

References 14 publications

Determinant of the Frequency of Short-Term Undesirable Events in Diabetes Discharged from the Emergency Department

Determinant of the Frequency of Short-Term Undesirable Events in Diabetes Discharged from the Emergency Department

Bridging Gaps in Diabetic Nephropathy Care: A Narrative Review Guided by the Lived Experiences of Patient Partners

Predictors of 30-day recurrent emergency department visits for hyperglycemia in patients with types 1 and 2 diabetes: a population-based cohort study

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