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03-03-2011 | Diabetes | Article

Many ED patients have undiagnosed or poorly controlled diabetes


Free abstract

MedWire News: Levels of previously undiagnosed or poorly controlled diabetes are higher than expected in the US population, suggest results from a study of emergency department (ED) attendees.

Michael Menchine (University of Southern California Keck School of Medicine, Los Angeles, USA) and colleagues collected glycated hemoglobin (HbA1c) data from 313 patients attending a single ED during eight 24-hour periods.

The team found that 48 (15%) patients had a previous history of diabetes. Of these, almost half (42%) had poorly controlled HbA1c, at a mean of 8.1%, compared with a mean of 5.8% among the rest of the patients with diabetes.

The screening also revealed a higher than expected number of patients (n=38; 14%) with previously undiagnosed diabetes. These patients had a mean HbA1c of 7.0% compared with a mean of 5.8% in the rest of the patients with no prior history of diabetes (n=227).

Menchine and co-authors found that the prevalence of previously undiagnosed diabetes was higher in African-American patients, at 27%, and those with a body mass index of 30 kg/m2 or higher, at 22%, than in the rest of the cohort. Hispanic-Americans had the same diabetes prevalence as the rest of the cohort, at 14%.

"These findings, coupled with new point-of-care HbA1C testing devices and HbA1C based definition of diabetes, may enhance the possibility of developing ED-based diabetes screening programs," write the researchers in the journal Academic Emergency Medicine.

"Future research should confirm these findings in a broader array of EDs, study the feasibility of such programs, and test novel mechanisms to link patients with previously undiagnosed and poorly controlled diabetes to active management programs," they suggest.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Helen Albert