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Screening for diabetes on a vascular ward: lessons from an audit
W P Stuart1, B Wolf, E M Macaulay
1Department of Vascular Surgery, Aberdeen Royal Infirmary, UK.
Journal of the Royal College of Surgeons of Edinburgh
|April 30, 1998
Summary
Screening for diabetes mellitus in vascular patients is crucial. Current random plasma glucose (RPG) testing is inadequate, necessitating improved protocols for early detection and management of diabetes in peripheral arterial disease patients.
Area of Science:
- Vascular Medicine
- Endocrinology
- Diabetes Mellitus Management
Background:
- High prevalence of diabetes mellitus in patients with peripheral arterial disease (PAD).
- Necessity of diabetes screening in vascular surgery settings.
- Review of current random plasma glucose (RPG) testing practices.
Purpose of the Study:
- To evaluate the adequacy of current random plasma glucose (RPG) testing for diabetes screening in patients with peripheral arterial disease (PAD).
- To propose improved screening and management protocols for diabetes in vascular patients.
Main Methods:
- Review of existing random plasma glucose (RPG) testing protocols for admitted patients.
- Analysis of RPG results, including abnormal findings and unrecorded tests.
- Development of a new three-step screening and referral protocol.
Main Results:
- 36% of patients had abnormal RPG results, but no further action was taken.
- 19% of patients had no RPG test results recorded.
- Current practice was deemed inadequate for effective diabetes screening.
Conclusions:
- Implementation of a new protocol: mandatory RPG for all patients with clinical evidence of arterial disease.
- Fasting plasma glucose estimation for patients with RPG > 6.0 mmol/L.
- Referral to diabetic clinic for patients with abnormal fasting plasma glucose levels is recommended.