Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients
Introduction: Diabetes screening traditionally occurs in primary care settings, but many who are at high risk face barriers to accessing care and therefore delays in diagnosis and treatment. These same high-risk patients do frequently visit emergency departments (ED) and, therefore, might benefit fr...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2023-08-01
|
| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/8fn9h7hd |
| _version_ | 1797660266949771264 |
|---|---|
| author | David C. Lee Harita Reddy Christian A. Koziatek Noah Klein Anup Chitnis Kashif Creary Gerard Francois Olumide Akindutire Robert Femia Reed Caldwell |
| author_facet | David C. Lee Harita Reddy Christian A. Koziatek Noah Klein Anup Chitnis Kashif Creary Gerard Francois Olumide Akindutire Robert Femia Reed Caldwell |
| author_sort | David C. Lee |
| collection | DOAJ |
| description | Introduction: Diabetes screening traditionally occurs in primary care settings, but many who are at high risk face barriers to accessing care and therefore delays in diagnosis and treatment. These same high-risk patients do frequently visit emergency departments (ED) and, therefore, might benefit from screening at that time. Our objective in this study was to analyze one year of results from a multisite, ED-based diabetes screening program. Methods: We assessed the demographics of patients screened, identified differences in rates of newly diagnosed diabetes by clinical site, and the geographic distribution of high and low hemoglobin A1c (HbA1c) results. Results: We performed diabetes screening (HbA1c) among 4,211 ED patients 40–70 years old, with a body mass index ≥25, and no prior history of diabetes. Of these patients screened for diabetes, 9% had a HbA1c result consistent with undiagnosed diabetes, and nearly half of these patients had a HbA1c ≥9.0%. Rates of newly diagnosed diabetes were notably higher at EDs located in neighborhoods of lower socioeconomic status. Conclusion: Emergency department-based diabetes screening may be a practical and scalable solution to screen high-risk patients and reduce health disparities experienced in specific neighborhoods and demographic groups. |
| first_indexed | 2024-03-11T18:27:20Z |
| format | Article |
| id | doaj.art-ca93a714bea742189b4504514166a579 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-03-11T18:27:20Z |
| publishDate | 2023-08-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-ca93a714bea742189b4504514166a5792023-10-13T16:02:13ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182023-08-0124596296610.5811/westjem.5995759957Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department PatientsDavid C. Lee0Harita Reddy1Christian A. Koziatek2Noah Klein3Anup Chitnis4Kashif Creary5Gerard Francois6Olumide Akindutire7Robert Femia8Reed Caldwell9New York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkNew York University, NYU Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, New YorkIntroduction: Diabetes screening traditionally occurs in primary care settings, but many who are at high risk face barriers to accessing care and therefore delays in diagnosis and treatment. These same high-risk patients do frequently visit emergency departments (ED) and, therefore, might benefit from screening at that time. Our objective in this study was to analyze one year of results from a multisite, ED-based diabetes screening program. Methods: We assessed the demographics of patients screened, identified differences in rates of newly diagnosed diabetes by clinical site, and the geographic distribution of high and low hemoglobin A1c (HbA1c) results. Results: We performed diabetes screening (HbA1c) among 4,211 ED patients 40–70 years old, with a body mass index ≥25, and no prior history of diabetes. Of these patients screened for diabetes, 9% had a HbA1c result consistent with undiagnosed diabetes, and nearly half of these patients had a HbA1c ≥9.0%. Rates of newly diagnosed diabetes were notably higher at EDs located in neighborhoods of lower socioeconomic status. Conclusion: Emergency department-based diabetes screening may be a practical and scalable solution to screen high-risk patients and reduce health disparities experienced in specific neighborhoods and demographic groups.https://escholarship.org/uc/item/8fn9h7hd |
| spellingShingle | David C. Lee Harita Reddy Christian A. Koziatek Noah Klein Anup Chitnis Kashif Creary Gerard Francois Olumide Akindutire Robert Femia Reed Caldwell Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients Western Journal of Emergency Medicine |
| title | Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients |
| title_full | Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients |
| title_fullStr | Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients |
| title_full_unstemmed | Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients |
| title_short | Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients |
| title_sort | expanding diabetes screening to identify undiagnosed cases among emergency department patients |
| url | https://escholarship.org/uc/item/8fn9h7hd |
| work_keys_str_mv | AT davidclee expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT haritareddy expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT christianakoziatek expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT noahklein expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT anupchitnis expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT kashifcreary expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT gerardfrancois expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT olumideakindutire expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT robertfemia expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients AT reedcaldwell expandingdiabetesscreeningtoidentifyundiagnosedcasesamongemergencydepartmentpatients |