Prevalence of Undiagnosed Diabetes in Patient with Random Serum Glucose Over 200 mg/dL in an Emergency Department in Korea: Preliminary Study

ABSTRACT

PURPOSE: The aim of this study was to determine the prevalence of diabetes in patients with random serum glucose over 200 mg/dL in an emergency department. METHODS: A retrospective descriptive pilot study was conducted using chart review of patients who have visited the ED at Kangdong Sacred Heart Hospital. Between April and October 2014, patients aged 18 years and older with random serum glucose level higher than 200 mg/dL and having no prior diabetes mellitus (DM) were enrolled. Regardless of the patient's chief complaint, a history of current symptoms related to diabetes of patients was obtained and additional serum HbA1c was measured. The follow-up test was recommended on endocrinology OPD or the inpatient ward. Patients' medical records regarding diagnosis of DM were reviewed. RESULTS: A total of 296 patients with random serum glucose level estimated above 200 mg/dL without previous DM history were enrolled in this study, however only 82 patients were eligible. Among them, 34 patients (41.4%) were newly diagnosed as DM; 38 patients had current presumptive symptoms of diabetes while 44 patients had none of those symptoms. Twenty three patients (60.5%) with presumptive diabetes symptoms were diagnosed as diabetes while another 15 patients (39.5%) were not. Eleven (25.0%) patients without symptoms of diabetes were diagnosed as diabetes while 33 patients (75.0%) were not. The difference between two groups was significant. (p=0.001) CONCLUSION: The prevalence of undiagnosed DM patients in patients with random serum glucose level over 200 mg/dL in the emergency department was considerably high. Therefore emergency physicians should pay attention to opportunistic hyperglycemia and active diabetes screening.