| Screening for type 2 diabetes with random finger-prick glucose and bedside HbA1c in an Australian emergency department. | |
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MedLine Citation:
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PMID: 21040483 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: To determine if screening for undiagnosed type 2 diabetes mellitus (T2DM) and pre-diabetes is feasible in an Australian ED; to estimate the prevalence of T2DM and pre-diabetes in the Australian ED population. METHODS: Prospective cross-sectional prevalence survey in the ED of St Vincent's Hospital, Melbourne, an adult, tertiary referral centre seeing approximately 40,000 patients annually. A convenience sample of adult patients was screened with finger-prick random blood glucose and glycosylated haemoglobin (HbA1c); those over 6.0 mmol/L and 6.0% were referred for oral glucose tolerance test (OGTT). Diagnoses of T2DM and pre-diabetes were made according to World Health Organization definitions. Those not attending for OGTT were contacted by phone, and interviewed about their reasons. RESULTS: Seven hundred and twenty-five patients were recruited; 135 (18.6%; 95% confidence intervals [CI] 15.9-21.6%) had known T2DM, leaving 590 screened, of whom 210 screened positive. Of the 192 referred for OGTT, 147 (77%) did not attend despite several telephone reminders. Of the 45 (23%) completing OGTT, pre-diabetes was present in eight (17.8%; 95% CI 9.0-31.6%) and T2DM in six (13.3%; 95% CI 5.9-26.6%). Many people interviewed (18/86, 21%) did not attend for OGTT on the advice of their doctors. CONCLUSIONS: This inner city tertiary ED has a high prevalence of T2DM, diagnosed and undiagnosed, with as much as half our population possibly affected. Although ED screening might have a high yield, opportunistic screening is not feasible, with difficulties in staff engagement and patient follow up for diagnostic testing. Future studies might consider finger-prick fasting blood glucose through a patient's general practitioner for diagnosis. |
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Authors:
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George A Jelinek; Tracey J Weiland; Gaye Moore; Grace Tan; Marg Maslin; Kath Bowman; Glenn Ward; Kerin O'Dea |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Emergency medicine Australasia : EMA Volume: 22 ISSN: 1742-6723 ISO Abbreviation: Emerg Med Australas Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101199824 Medline TA: Emerg Med Australas Country: Australia |
Other Details:
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Languages: eng Pagination: 427-34 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. Emergency Medicine Australasia © 2010 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine. |
Affiliation:
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St Vincent's Hospital, Fitzroy, Victoria, Australia. george.jelinek@svhm.org.au |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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