Routine glucose assessment in the emergency department for detecting unrecognised diabetes: A cluster randomised trial

Journal article


Cheung, N. Wah, Campbell, Lesley V., Fulcher, Gregory R., McElduff, Patrick, Depczynski, Barbara, Acharya, Shamasunder, Carter, John, Champion, Bernard L., Chen, Roger, Chipps, David, Flack, Jeff, Kinsella, Jen, Layton, Margaret, McLean, Mark, Moses, Robert G., Park, Kris, Poynten, Ann M., Pollock, Carol, Scadden, Debbie, ... Middleton, Sandy. (2019) Routine glucose assessment in the emergency department for detecting unrecognised diabetes: A cluster randomised trial. Medical Journal of Australia. 211(10), pp. 454 - 459. https://doi.org/10.5694/mja2.50394
AuthorsCheung, N. Wah, Campbell, Lesley V., Fulcher, Gregory R., McElduff, Patrick, Depczynski, Barbara, Acharya, Shamasunder, Carter, John, Champion, Bernard L., Chen, Roger, Chipps, David, Flack, Jeff, Kinsella, Jen, Layton, Margaret, McLean, Mark, Moses, Robert G., Park, Kris, Poynten, Ann M., Pollock, Carol, Scadden, Debbie, Tonks, Katherine T., Webber, Mary, White, Christopher, Wong, Vincent and Middleton, Sandy
Abstract

Objective To determine whether routine blood glucose assessment of patients admitted to hospital from emergency departments (ED s) results in higher rates of new diagnoses of diabetes and documentation of follow‐up plans. Design, setting Cluster randomised trial in 18 New South Wales public district and tertiary hospitals, 31 May 2011 – 31 December 2012; outcomes follow‐up to 31 March 2016. Participants Patients aged 18 years or more admitted to hospital from ED s. Intervention Routine blood glucose assessment at control and intervention hospitals; automatic requests for glycated haemoglobin (HbA1c) assessment and notification of diabetes services about patients at intervention hospitals with blood glucose levels of 14 mmol/L or more. Main outcome measure New diagnoses of diabetes and documented follow‐up plans for patients with admission blood glucose levels of 14 mmol/L or more. Results Blood glucose was measured in 133 837 patients admitted to hospital from an ED . The numbers of new diabetes diagnoses with documented follow‐up plans for patients with blood glucose levels of 14 mmol/L or more were similar in intervention (83/506 patients, 16%) and control hospitals (73/278, 26%; adjusted odds ratio [aOR ], 0.83; 95% CI 0.42–1.7; P = 0.61), as were new diabetes diagnoses with or without plans (intervention, 157/506, 31%; control, 86/278, 31%; aOR , 1.51; 95% CI , 0.83–2.80; P = 0.18). 30‐day re‐admission (31% v 22%; aOR , 1.34; 95% CI , 0.86–2.09; P = 0.21) and post‐hospital mortality rates (24% v 22%; aOR , 1.07; 95% CI , 0.74–1.55; P = 0.72) were also similar for patients in intervention and control hospitals. Conclusion Glucose and HbA1c screening of patients admitted to hospital from ED s does not alone increase detection of previously unidentified diabetes. Adequate resourcing and effective management pathways for patients with newly detected hyperglycaemia and diabetes are needed.

Keywordsdiabetes mellitus; type 2 diabetes; hospital medicine; diagnosis; health services research
Year2019
JournalMedical Journal of Australia
Journal citation211 (10), pp. 454 - 459
PublisherJohn Wiley & Sons, Inc.
ISSN0025-729X
Digital Object Identifier (DOI)https://doi.org/10.5694/mja2.50394
Scopus EID2-s2.0-85074766459
Page range454 - 459
Research GroupNursing Research Institute
Publisher's version
File Access Level
Controlled
Grant IDNHMRC/1013443
Place of publicationAustralia
Permalink -

https://acuresearchbank.acu.edu.au/item/89400/routine-glucose-assessment-in-the-emergency-department-for-detecting-unrecognised-diabetes-a-cluster-randomised-trial

Restricted files

Publisher's version

  • 4
    total views
  • 0
    total downloads
  • 0
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Nurse-led primary health care for homeless men: A multimethods descriptive study
Roche, M. A., Duffield, C., Smith, J., Kelly, D., Cook, R., Bichel-Findlay, J., Saunders, C. and Carter, D. J.. (2018) Nurse-led primary health care for homeless men: A multimethods descriptive study. International Nursing Review. 65(3), pp. 392 - 399. https://doi.org/10.1111/inr.12419
Ars Poetica, Romanticism and English education: Poetic inheritances in the senior secondary English curriculum in New South Wales, Australia
Carter, Donald John. (2013) Ars Poetica, Romanticism and English education: Poetic inheritances in the senior secondary English curriculum in New South Wales, Australia. English Teaching: Practice and Critique. 12(1), pp. 46 - 63.
Ars Poetica, Romanticism and English education: Poetic inheritances in the senior secondary English curriculum in New South Wales, Australia
Carter, Donald John. (2013) Ars Poetica, Romanticism and English education: Poetic inheritances in the senior secondary English curriculum in New South Wales, Australia. English Teaching: Practice and Critique. 12(1), pp. 46 - 63.
Teenagers and reading in school: Some observations on Australian senior secondary English reading lists
Carter, Donald. (2012) Teenagers and reading in school: Some observations on Australian senior secondary English reading lists. In In Jacqueline Manuel and Sue Brindley (Ed.). pp. 128 - 140 Wakefield Press.
Something Grand and Lustrous: Some Reflections on Creativity in Subject English and Beyond
Carter, Donald John. (2009) Something Grand and Lustrous: Some Reflections on Creativity in Subject English and Beyond. In Imagination Innovation Creativity - Re-Visioning English in Education pp. 159 - 170 Phoenix Education.
What is within becomes what is around: Imagination, Innovation, Creativity
Manuel, Jacqueline, Brock, Paul, Sawyer, Wayne and Carter, Donald John. (2009) What is within becomes what is around: Imagination, Innovation, Creativity. In In J. Manuel, P. Brock and D. Carter (Ed.). Imagination Innovation Creativity - Re-Visioning English in Education pp. 7 - 12 Phoenix Education.