title: Prevalence of undiagnosed hyperglycaemia in patients presenting to the Department of Emergency Medicine with no known history of diabetes.
abstract: BACKGROUND
  Diabetes is considered a major epidemic of the 21st century. Usually, diabetes begins asymptomatically and the diagnosis takes place an average of 8-12 years after the onset of dysglycaemia. Blood check for glucose is taken at different medical setting, whether at the fasting condition or randomly. Previous studies had shown that abnormal blood glucose predicts future diabetes. Hence, medical staff should consider taking reasonable actions in patients with abnormal blood glucose.
  
  
  OBJECTIVE
  To assess the prevalence of hyperglycaemia in patients presenting to the Department of Emergency Medicine (DEM) with no known history of diabetes, and to evaluate how often were they recommended following this up as an outpatient by the medical staff.
  
  
  METHODS
  A cross-sectional study examined the medical records of adult patients referred to the DEM during 1 November 2011-31 January 2012.
  
  
  METHODS
  Patients with random blood glucose ≥140 mg/dL and no known history of diabetes were included in the study. The discharge letter was examined for the presence of instructions to conduct further follow up.
  
  
  RESULTS
  A total of 16 784 patients presented to the DEM. Of these, 402 patients (2.4%) without known diabetes were hyperglycaemic, 346 patients had blood glucose levels ≥140 mg/dL and 56 patients had blood glucose levels above 200 mg/dL. Only 35 of the 402 included patient files (8.7%) contained instructions for further investigation. There was no statistically significant difference between those who received a letter for further follow up compared with those who did not receive it with respect to age, sex or blood glucose levels.
  
  
  CONCLUSIONS
  Over 2% of patients who presented to the DEM were hyperglycaemic, without a prior diagnosis of diabetes. A small per cent was recommended to have outpatient follow-up. This represents a missed opportunity for earlier diagnosis of diabetes and emphasised the need for raising medical staff awareness concerning abnormal blood glucose and its implication.
authors.affiliation: Diabetes Unit, Wolfson Medical Center, Holon, Israel. bardayan@netvision.net.il.|Sackler Faculty of Medicine, Tel Aviv, Israel. bardayan@netvision.net.il.
authors.forename: Yosefa
authors.initials: Y
authors.lastname: Bar-Dayan
authors.affiliation: Department of Radiology, Wolfson Medical Center, Holon, Israel.
authors.forename: Irena
authors.initials: I
authors.lastname: Zilberman
authors.affiliation: Epidemiology and Research Unit, Wolfson Medical Center, Holon, Israel.|Department of Nutrition Science, Faculty of Health, Ariel University, Ariel, Israel.
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv, Israel.|Pediatric Diabetes Unit, Wolfson Medical Center, Holon, Israel.
authors.forename: Zohar
authors.initials: Z
authors.lastname: Landau
authors.affiliation: Diabetes Medical Center, Tel Aviv, Israel.|Bronx-Lebanon Hospital, Bronx, NY, USA.
authors.forename: Mariela
authors.initials: M
authors.lastname: Glandt
authors.affiliation: Diabetes Unit, Wolfson Medical Center, Holon, Israel.|Sackler Faculty of Medicine, Tel Aviv, Israel.
authors.forename: Daniela
authors.initials: D
authors.lastname: Jakubowicz
authors.affiliation: Diabetes Unit, Wolfson Medical Center, Holon, Israel.|Sackler Faculty of Medicine, Tel Aviv, Israel.
authors.forename: Julio
authors.initials: J
authors.lastname: Wainstein
mesh_terms: D000359:Aftercare; D000553:Ambulatory Care; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000628:therapy; D007557:Israel; D008297:Male; D008875:Middle Aged; D063886:Patient Discharge Summaries; D011446:Prospective Studies; D012017:Referral and Consultation
chemical_list: D001786:Blood Glucose