Hyperglycemia in ED patients with no history of diabetes

Prince, Louise A.; Rodriquez, Elliot; Campagna, James D.; Brown, Lawrence H.; Fischer, Daisy; Grant, William D.

doi:10.1016/j.ajem.2007.08.009

Cited by 10 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the discussion of the implication of these findings, it is important to acknowledge the established fact that acute stress results in a physiologic elevation of glucose. 6 However, the findings from the study conducted by Silverman et al showed a significant correlation between hyperglycemia and HbA1c levels among the non-diabetic patients in the emergency department, suggesting that emergency hyperglycemia indicates undiagnosed diabetes. 7 Similarly Ginde et al estimated the risk for undiagnosed diabetes in emergency patients using ADA risk score and found that 33% were at high risk for undiagnosed diabetes and 42% had elevated risk.…”

Section: Discussionmentioning

confidence: 93%

Incidental Hyperglycemia and Detection of Diabetes in Patients Presenting to the Emergency Department of a Tertiary Care Hospital

2020

View full text Add to dashboard Cite

Introduction: Nearly half of people with diabetes don’t know they have it. It is often not diagnosed until complications appear. The aim of the study was to determine the prevalence of diabetes mellitus and prediabetes in patients presenting to the Emergency Department with incidental hyperglycemia, because the duration of hyperglycemia is a predictor of adverse outcomes, and there are effective interventions to prevent disease progression and to reduce complications. Methods: It was an observational cross-sectional study, 720 patients from Emergency Department of Kathmandu Medical College, Sinamangal were screened from December 2018 to March 2019 and a total of 128 patients with incidental hyperglycemia (>140mg/dl) were included. Patients with a previous diagnosis of diabetes, unstable patients and pregnant patients were excluded. Incidental hyperglycemia, fasting blood sugar, 2 hours postprandial blood sugar and HbA1c were noted, data entry was done in Microsoft Excel and analysis was done using the SPSS 24. Results: Total of 128 patients were enrolled for the study.10% of the patients had hyperglycemia and 34% among the hyperglycemic had the finding in the absence of history of diabetes. Incidental hyperglycemia ranged from 150-500 mg/dl. Among the incidental hyperglycemic, 29% and 36% had prediabetes and diabetes respectively. Incidental hyperglycemia was divided into four groups; <159, 160-179, 180-199 and >200 mg/dl, and each group was analyzed with the diagnostic criteria and the final outcome. It was found that each group correlated well with the diagnostic criteria and final outcome and was found to be statistically significant with p<0.0001 based on the Chi square test. Conclusions: Following the patients with incidental hyperglycemia in the Emergency Department, a significant number of undiagnosed diabetes or prediabetes can be diagnosed, early intervention can be started that can prevent progression from prediabetes to diabetes and risk of complications can be reduced.

show abstract

Section: Discussionmentioning

confidence: 93%

Incidental Hyperglycemia and Detection of Diabetes in Patients Presenting to the Emergency Department of a Tertiary Care Hospital

2020

View full text Add to dashboard Cite

show abstract

“…It has been reported that 2.6% of patients examined in the DEM had undiagnosed diabetes and 1.6% had glucose levels suggestive of impaired fasting glucose . Another study reported that 0.8% of the DEM population presented with serum glucose levels >200 mg/dL …”

Section: Discussionmentioning

confidence: 99%

“…20 Another study reported that 0.8% of the DEM population presented with serum glucose levels >200 mg/dL. 21 The definition of hyperglycaemia in a hospital setting remains unclear. It can be a challenge to differentiate between stress-induced hyperglycaemia, resulting from the acute metabolic and hormonal changes associated with the response to injury and stress and hyperglycaemia which represents a new or unknown diagnosis of diabetes.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of undiagnosed hyperglycaemia in patients presenting to the Department of Emergency Medicine with no known history of diabetes

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Current literature demonstrated poor outcomes in ED patients with BG level above 200 mg/dL 2–6. Our work group selected an admission BG goal of below 250 mg/dL to improve outcomes while balancing the risk of hypoglycemia.…”

Section: Methodsmentioning

confidence: 99%

“…Current American Diabetes Association guidelines recommend the use of insulin-based treatment in hospitalized patients to achieve blood glucose (BG) level of 140 to 180 mg/dL 1. Hyperglycemia in this patient population has been associated with poor outcomes including increased mortality and hospital length of stay (LOS) 2–6. Patients with and without a history of diabetes mellitus (DM) experienced these negative sequelae 4,7,8…”

mentioning

confidence: 99%

Hyperglycemia Management Prior to Admission in an Urban Emergency Department

Benbrahim

Cashman

Baker

et al. 2022

Quality Management in Health Care

View full text Add to dashboard Cite

Background and Objectives: The aim of this quality improvement project was to decrease the percentage of emergency department (ED) patients admitted with blood glucose (BG) level above 250 mg/dL to less than 20%. Methods: A work group comprised physicians, pharmacists, and endocrinologists collaborated to standardize management of ED hyperglycemia. Plan-Do-Study-Act cycles included education, monitoring of patients with BG level above 200 mg/dL, and development of an ED-specific insulin protocol. Results: Following the initiative, 24.8% fewer patients were admitted with BG level above 250 mg/dL. The average admission BG level was reduced by 65.8 mg/dL, creating a significant shift toward improved average BG level. No difference was seen in hospital mortality, hospital length of stay, ED length of stay, hypoglycemia, or inhospital diabetic ketoacidosis or hyperglycemic hyperosmolar syndrome. Conclusion: Implementation of a standardized hyperglycemia treatment protocol along with pharmacist interventions reduced average admission BG and the percentage of patients with BG level above 250 mg/dL on admission.

show abstract

Hyperglycemia in ED patients with no history of diabetes

Cited by 10 publications

References 15 publications

Incidental Hyperglycemia and Detection of Diabetes in Patients Presenting to the Emergency Department of a Tertiary Care Hospital

Incidental Hyperglycemia and Detection of Diabetes in Patients Presenting to the Emergency Department of a Tertiary Care Hospital

Prevalence of undiagnosed hyperglycaemia in patients presenting to the Department of Emergency Medicine with no known history of diabetes

Hyperglycemia Management Prior to Admission in an Urban Emergency Department

Contact Info

Product

Resources

About