Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients

Area of Science:

• Public Health
• Endocrinology
• Emergency Medicine

Background:

• Traditional diabetes screening in primary care faces access barriers for high-risk individuals.
• Emergency departments (EDs) are frequently visited by high-risk populations, presenting an opportunity for screening.
• Early diagnosis and treatment of diabetes are crucial for preventing complications.

Purpose of the Study:

• To analyze the results of a multisite, emergency department-based diabetes screening program over one year.
• To assess the feasibility and effectiveness of ED-based diabetes screening.
• To identify demographic and geographic disparities in diabetes diagnosis rates.

Main Methods:

• Screened 4,211 emergency department patients aged 40-70 with a body mass index ≥25 and no prior diabetes history.
• Utilized hemoglobin A1c (HbA1c) testing for diabetes screening.
• Analyzed patient demographics, HbA1c results, and variations by clinical site and socioeconomic status.

Main Results:

• 9% of screened patients had HbA1c levels indicative of undiagnosed diabetes.
• Nearly half of those with undiagnosed diabetes had an HbA1c ≥9.0%.
• Higher rates of newly diagnosed diabetes were observed in EDs located in lower socioeconomic status neighborhoods.

Conclusions:

• Emergency department-based diabetes screening is a practical and scalable method for identifying high-risk individuals.
• This screening strategy has the potential to reduce health disparities among specific demographic and geographic groups.
• ED screening can facilitate timely diagnosis and linkage to care for underserved populations.