Frequency and management of diabetes and hyperglycemia at emergency departments: the GLUCE-URG Study.

INTRODUCTION: Hyperglycemia is a common finding at hospital emergency rooms in diabetic patients, but few data are available on its frequency, management, and subsequent impact based on the assessment made at Emergency rooms.

OBJECTIVES: To ascertain the frequency of diabetes mellitus and hyperglycemia in patients admitted from Emergency rooms. Second, to describe management of hyperglycemia at Emergency rooms, and to analyze its potential impact on the course and management of patients during admission.

PATIENTS AND METHODS: All patients admitted from the Emergency room for three consecutive weeks were enrolled. Hyperglycemia was defined as two blood glucose measurements ≥ 180mg/dl in the first 48hours after admission.

RESULTS: 36.6% of patients admitted from the Emergency room were diabetic, and 58% of these had early, sustained hyperglycemia. On the other hand, 27% of patients admitted from the Emergency room had hyperglycemia (78.3% of diabetic patients and 21.7% with no known diabetes). Diabetic patients with hyperglycemia had higher blood glucose levels than non-diabetic patients (p<.01). Average hospital stay was 8±6.4 days, with no differences between the groups. Hyperglycemia is rarely reported as a diagnosis in the emergency rooms discharge report. In standard hospitalization, this diagnosis appears more commonly in patients with known diabetes (OR 2.5 p<.001).

CONCLUSIONS: Prevalence of diabetic patients admitted from emergency rooms is very high. In addition, although hyperglycemia is very common in patients admitted from emergency rooms, there is a trend to underestimate its significance. Based on our results, we think that implementation of measures to give greater visibility to diagnosis of hyperglycemia could help improve application of established protocols.