Undiagnosed Diabetes in Patients Admitted to a Clinical Decision Unit from the Emergency Department: A Retrospective Review

Abstract

ObjectivesDiabetes is a debilitating disease that affects the way the body uses or produces insulin. Research evaluating the usefulness in screening patients admitted to a clinical decision unit (CDU) from the emergency department (ED) has been limited.MethodsA retrospective chart review of patients admitted to a CDU from the ED was performed. Patients included were > 18-year-old who were observed in the CDU, had blood glucose drawn greater than eight hours after admission, and who had not been previously diagnosed with diabetes. Age, sex, and fasting glucose level were collected. The analysis was done to evaluate the percentage of patients undiagnosed and at risk for diabetes mellitus by assessing fasting blood glucose the morning after admission.ResultsStudy revealed that 27.8% of the patients analyzed in this study had fasting blood glucose levels meeting or exceeding the diagnostic threshold of 126 mg/dL and could potentially have undiagnosed diabetes.ConclusionScreening patients admitted to a CDU from the emergency department identified that 27.8% had fasting plasma glucose levels ≥ 126 mg/dL. Consideration should be made to obtain a fasting blood glucose level in those without a previous diagnosis of diabetes who are observed overnight in a CDU.

Determination of Frequency of a Novel Diagnostic Category of Hyperglycemia I.E. Impaired Random Glucose in Previously Unknown Patients of Prediabetes and Diabetes Mellitus

“…Many studies have shown that RPG can detect significant proportion of undiagnosed DM and prediabetes when combined with appropriate definitive diagnostic test like OGTT, FPG and A1C 9 . A study conducted by Friedman et al 10 , in 2013 revealed a frequency of 12.5% of DM when elevated screening RPG was followed with OGTT while another study conducted by Barasch et al 11 , revealed frequency of 12.2% and 5.7% for DM and prediabetes respectively when healthy individuals underwent screening RPG.…”

The potential for utilising in‐hospital glucose measurements to detect individuals at high risk of previously undiagnosed diabetes: Retrospective cohort study

“…Of the population, 70.7% of individuals declared themselves to be of White ethnicity, 3.1% of Asian background and 1.1% of Black background, with 23.1% unstated. The median number of admissions was 2, 1,3 and median length of admission was 1.3 (0.3, 3.5) days.…”

“…The authors report that automatically triggering HbA1c measurements in their intervention group did not lead to increased rates of diabetes diagnoses in hospital 6 . Another Australian study used a cut‐off of 5.5 mmol/L among people presenting to the emergency department to trigger HbA1c measurement 3 . They found that 11% of those tested had HbA1c measurements consistent with diabetes 7 .…”

Pemberdayaan Kader Kesehatan Pada Diabetes Melitus Tipe 2 Di Puskesmas Pancur Batu, Deli Serdang

“…Akan tetapi penderita DM yang tidak terdiagnosis sebanyak 7,6 juta orang atau setara dengan 73,7%. Penderita DM sering tidak terdiagnosis selama bertahun-tahun, sehingga mereka baru sadar akan penyakitnya setelah muncul komplikasi (Sop et al, 2018). Kondisi ketidaktahuan mengalami DM ini tidak hanya terjadi di negara yang sedang berkembang, studi penelitian yang dilakukan oleh Bernal-Soriano et al (2021) menemukan bahwa 77% kebutuhan perawatan diabetes tidak terpenuhi akan menimbulkan beberapa komplikasi makro dan mikro Diabetes Melitus.…”