Background: Despite being a common comorbidity, diabetes is often overlooked when patients present to the emergency department (ED) with nondiabetic emergencies.
Aims: To examine the associations between insulin treated patients presenting to the ED with nondiabetic emergencies and;
(i) adverse glycaemia (AG); including hypoglycaemia (< 70 mg/dL) and hyperglycaemia (< 180 mg/dL) and insulin prescribing errors,
(ii) glycaemic variability and AG following ED evaluation and ward diabetes management.
Methods: A two-year retrospective medical record audit of discharged insulin treated adult patients (≥ 18 years) was conducted at a quaternary hospital. All patients presented to the ED with nondiabetic emergencies and admitted to general wards for > 24 hours and < 30 days.
Results: Of the 103 patients (Table), 25 (24%) had one or more prescribing errors charted in the ED. Thirty-nine (37.8%) patients experienced hypoglycaemia. Of these, 21 (53.8%) were prescribed sliding scale insulin (SSI) in the ED (p = 0.05). Despite uncontrolled hyperglycaemia, 40 (47.6%) patients had no change to their diabetes treatment during admission (p = 0.04).
Conclusions: Half of insulin treated patients experienced uncontrolled hyperglycaemia. Use of SSI regimens prescribed in the ED were associated with higher risk of AG. Safety for insulin treated patients should be prioritised from the time the hospital journey begins in ED to after discharge.
S.L. Patterson: None. E.I. Ekinci: None. A. Driscoll: None. B. Rasmussen: None.