Many ED patients have undiagnosed or poorly controlled diabetes
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.
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By Helen Albert