Trends in Emergency Department Visits and Inpatient Admissions for Hyperglycemic Crises in Adults With Diabetes in the U.S., 2006–2015

Benoit, Stephen R.; Hora, Israel; Pasquel, Francisco J.; Gregg, Edward W.; Albright, Ann; Imperatore, Giuseppina

doi:10.2337/dc19-2449

Cited by 81 publications

(70 citation statements)

References 28 publications

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“…Heart disease is the leading cause of death, and stroke is the fifth leading cause of death in the United States † † : someone in the United States has a heart attack every 40 seconds, § § and approximately 795,000 persons have a stroke annually. ¶ ¶ Diabetes affects 34 million Americans,*** and uncontrolled hyperglycemia (high blood glucose), can lead to diabetic ketoacidosis or a hyperosmolar hyperglycemic state, life-threatening but preventable metabolic complications of diabetes (8). It is important for all persons to know the warning signs of MI, stroke, and hyperglycemic ** https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e5.htm.…”

Section: Discussionmentioning

confidence: 99%

Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020

Lange¹,

Ritchey²,

Goodman³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

Self Cite

315

288

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On March 13, 2020, the United States declared a national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic. Subsequently, states enacted stay-athome orders to slow the spread of SARS-CoV-2, the virus that causes COVID-19, and reduce the burden on the U.S. health care system. CDC* and the Centers for Medicare & Medicaid Services (CMS) † recommended that health care systems prioritize urgent visits and delay elective care to mitigate the spread of COVID-19 in health care settings. By May 2020, national syndromic surveillance data found that emergency department (ED) visits had declined 42% during the early months of the pandemic (1). This report describes trends in ED visits for three acute life-threatening health conditions (myocardial infarction [MI, also known as heart attack], stroke, and hyperglycemic crisis), immediately before and after declaration of the COVID-19 pandemic as a national emergency. These conditions represent acute events that always necessitate immediate emergency care, even during a public health emergency such as the COVID-19 pandemic. In the 10 weeks following the emergency declaration (March 15-May 23, 2020), ED visits declined 23% for MI, 20% for stroke, and 10% for hyperglycemic crisis, compared with the preceding 10-week period (January 5-March 14, 2020). EDs play a critical role in diagnosing and treating life-threatening conditions that might result in serious disability or death. Persons experiencing signs or symptoms of serious illness, such as severe chest pain, sudden or partial loss of motor function, altered mental state, signs of extreme hyperglycemia, or other life-threatening issues, should seek immediate emergency care, regardless of the pandemic. Clear, frequent, highly visible communication from public health and health care professionals is needed to reinforce the importance of timely care for medical emergencies and to assure the public that EDs are implementing infection prevention and control guidelines that help ensure the safety of their patients and health care personnel.

show abstract

Section: Discussionmentioning

confidence: 99%

Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020

Lange¹,

Ritchey²,

Goodman³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

Self Cite

315

288

View full text Add to dashboard Cite

show abstract

“…Heart disease is the leading cause of death, and stroke is the fifth leading cause of death in the United States †† : someone in the United States has a heart attack every 40 seconds, §§ and approximately 795 000 persons have a stroke annually ¶¶ . Diabetes affects 34 million Americans, *** and uncontrolled hyperglycemia (high blood glucose), can lead to diabetic ketoacidosis or a hyperosmolar hyperglycemic state, life‐threatening but preventable metabolic complications of diabetes 8 . It is important for all persons to know the warning signs of MI, stroke, and hyperglycemic crisis ††† and understand that immediate medical attention for these acute issues can prevent serious heart or brain damage, metabolic complications of diabetes, or death.…”

Section: Discussionmentioning

confidence: 99%

Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions — United States, January–May 2020

Lange

Ritchey

Goodman

et al. 2020

American Journal of Transplantation

Self Cite

155

144

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“…1 HbA1C levels are higher, 2 use of technology is lower, 3 and hospitalization rates for diabetic ketoacidosis (DKA) are increased. 4 This high-risk population seems particularly vulnerable to suffering from a loss of access to health care and life-sustaining insulin therapy in the midst of a health care system struggling to contain a global pandemic. However, at least anecdotally, in some circumstances people with T1D may be receiving better care, not worse.…”

Section: Introductionmentioning

confidence: 99%

The Silver Lining to COVID-19: Avoiding Diabetic Ketoacidosis Admissions with Telehealth

Peters

Garg

2020

Diabetes Technology & Therapeutics

105

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Background: The Stay at Home order in Colorado and The Stay Safe at Home order in California during COVID-19 pandemic have forced a majority of the endocrinologists/diabetologists to adapt to providing diabetes care remotely through telehealth. This may provide increased access to diabetes health care in certain settings. However, health care disparities continue to challenge availability of diabetes technologies for underprivileged communities. We report our experience with two patients providing diabetes care effectively and preventing hospital admissions by using telehealth. Methods: Two adult patients with type 1 diabetes (T1D): one new onset and the other one with established T1D are presented where telehealth facilitated by Clarity Software and the ''Share'' feature with the use of Dexcom G6 continuous glucose monitoring (CGM) for management of diabetic ketosis and hyperglycemia. Results: Both patients were managed effectively virtually despite higher risk of diabetic ketoacidosis (DKA). Shared glucose data through CGM facilitated frequent insulin dose adjustments, increased fluid and carbohydrate intake, and prevented hospital admissions in both cases. In the case of new onset patient with T1D, most of the education was done remotely by certified diabetes care and education specialists. Conclusion: Acute diabetes complication like DKA increases morbidity and mortality in addition to adding cost to the health care system. The current pandemic of COVID-19 has allowed newer ways (with the help of newer technologies) to manage high-risk patients with T1D and DKA through telehealth and may result in lasting benefits to people with T1D.

show abstract

Trends in Emergency Department Visits and Inpatient Admissions for Hyperglycemic Crises in Adults With Diabetes in the U.S., 2006–2015

Abstract: To report U.S. national population-based rates and trends in diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) among adults, in both the emergency department (ED) and inpatient settings.

Cited by 81 publications

References 28 publications

Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020

Potential Indirect Effects of the COVID-19 Pandemic on Use of Emergency Departments for Acute Life-Threatening Conditions — United States, January–May 2020

Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions — United States, January–May 2020

The Silver Lining to COVID-19: Avoiding Diabetic Ketoacidosis Admissions with Telehealth

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