Sentinel visits in emergency department patients with diabetes mellitus as a warning sign for hyperglycemic emergencies

Yan, Justin; Gushulak, K.; Columbus, M.; Hamelin, A.; Wells, George A.; Stiell, Ian G.

doi:10.1017/cem.2017.338

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…The London Health Sciences Centre is an academic tertiary-care centre affiliated with Western University consisting of 2 EDs with a combined annual census of 150,000 visits and serves as the major referral centre for southwestern Ontario (catchment area w1.8 million people). The study protocol was approved by the health sciences research ethics board of Western University and was an a priori planned analysis of a subset of patients enrolled in a larger, multicentre, retrospective cohort study of ED patients presenting with hyperglycemia (7,8).…”

Section: Methodsmentioning

confidence: 99%

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

Liu

Aarsen

et al. 2021

Canadian Journal of Diabetes

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Few studies have examined the effect of specialized diabetes care on patients who present to the emergency department for hyperglycemia. Patients followed by specialized diabetes clinics were less likely to have a recurrent emergency visit and require hospitalization for hyperglycemia within 30 days. Future studies involving close endocrinology and emergency medicine collaboration may help reduce recurrent emergency department visits and admissions for hyperglycemia.

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Section: Methodsmentioning

confidence: 99%

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

Liu

Aarsen

et al. 2021

Canadian Journal of Diabetes

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show abstract

“…When patients who applied to the emergency department with diabetic complications were examined, it was shown in a retrospective study that the rate of admission to the emergency department within 14 days was 17% [10]. In our prospective study, it was found that this rate was 40.6% for the rst 7 days, when all hospital admissions (including the outpatient clinic) were taken into account.…”

Section: Discussionmentioning

confidence: 58%

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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“…2 Diabetic ketoacidosis and other acute hyperglycemic emergencies (e.g., hyperosmolar hyperglycemic state, which is treated similarly) tend to recur in individuals with poorly controlled diabetes mellitus, resulting in frequent, unplanned repeat ED visits (almost 20% within a 30-day period in one recent Canadian study including diabetic ketoacidosis and hyperosmolar hyperglycemic state patients). 3…”

Section: What Is the Epidemiology Of Diabetic Ketoacidosis?mentioning

confidence: 99%

Just the Facts: Diagnosis and treatment of diabetic ketoacidosis in the emergency department

Yan

Spaic

Liu

2019

CJEM

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A 21-year-old male with known type 1 diabetes mellitus presented to the emergency department (ED) with two days of vomiting, polyuria, and polydipsia after several days of viral upper respiratory tract infection symptoms. Since his symptom onset, his home capillary blood glucose readings have been higher than usual. On the day of presentation, his glucometer read “high,” and he could not tolerate oral fluids. On examination, his pulse was 110 beats/minute, and his respiratory rate was 24 breaths/minute. He was afebrile, and the remaining vital signs were normal. Other than dry mucous membranes, his cardiopulmonary, abdominal, and neurologic exams were unremarkable. Venous blood gas demonstrated a pH of 7.25 mm Hg, pCO2 of 31 mm Hg, HCO3 of 13 mm Hg, anion gap of 18 mmol/L, and laboratory blood glucose of 40 mmol/L, as well as serum ketones measuring “large.”

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Sentinel visits in emergency department patients with diabetes mellitus as a warning sign for hyperglycemic emergencies

Cited by 10 publications

References 16 publications

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?

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?

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

Just the Facts: Diagnosis and treatment of diabetic ketoacidosis in the emergency department

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