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

Jessica Sop,Alfred Tager,Frank H Annie,Mark Gustafson,Clyde Rorrer

doi:10.7759/cureus.3390

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.

Highlights

Diabetes and its associated complications pose a major health dilemma worldwide
Patients included were > 18-year-old who were observed in the clinical decision unit (CDU), had blood glucose drawn greater than eight hours after admission, and who had not been previously diagnosed with diabetes
Study 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

Summary

Introduction

Diabetes and its associated complications pose a major health dilemma worldwide. In theHow to cite this article Sop J, Gustafson M, Rorrer C, et al (October 01, 2018) Undiagnosed Diabetes in Patients Admitted to a Clinical Decision Unit from the Emergency Department: A Retrospective Review. The percentage of patients with controlled diabetes has only increased by 1.5% from 1999 to 2012. The lack of control, high prevalence, and large number of undiagnosed patients place a significant burden on the healthcare system. In 2015, diabetes was the 15th highest contributor to years of life lost and had a global economic burden of $1.3 trillion dollars. This is projected to increase to over $2.1 trillion dollars by 2030 [3]. The American Heart Association (AHA) recognizes diabetes as one of the seven major controllable risk factors for cardiovascular diseases [5]. The risks of complications from diabetes may be lowered when blood glucose levels are kept under control

Objectives

Methods

Conclusion