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Prevalence of undiagnosed dysglycemia in an emergency department observation unit

Silverman, Robert A; Schleicher, Mackenzie G; Valente, Christopher J; Kim, Mark; Romanenko, Yevgeniy; Schulman, Rifka C; Tiberio, Allison; Greenblatt, Benjamin; Rentala, Manju; Salvador-Kelly, Annabella V; Kwon, Nancy S; Jornsay, Donna L
BACKGROUND: The proposed 2015 United States Preventive Services Task Force guidelines recommend diabetes screening for individuals >/=45 years or demonstrating other risk factors for dysglycemia. Still, many patients with dysglycemia remain undiagnosed and opportunities for early intervention are lost. METHODS: To test novel approaches for diagnosis using a Hemoglobin A1c (HbA1c ) test, we screened adult patients who were admitted to an observation unit from the emergency department with no known history of pre-diabetes or diabetes. RESULTS: Of 256 subjects, 9% were newly diagnosed with diabetes and 52% were newly diagnosed with pre-diabetes. Of those aged 18-29 years, 33% were newly diagnosed with dysglycemia, while 55% of those aged 30-44 years and 70% of those aged >/=45 years were newly diagnosed with dysglycemia. CONCLUSIONS: Our results suggest that regardless of age, large proportions of patients in the emergency department observation unit have undiagnosed dysglycemia, an important finding given the large number of observation admissions
PMID: 26104580
ISSN: 1520-7560
CID: 1662462