Background: Patients with hyperglycemia often seek care in the emergency department (ED). Hyperglycemia is associated with longer hospital stays and increased risk of mortality.

Methods: Using electronic health record data from patients ≥18 seen at an academic medical center ED (11/1/2015-12/31/2020), we described presentation of non-emergent hyperglycemia (blood glucose (BG) 180-600mg/dL) and examined associations between insulin receipt in ED and in-hospital mortality and hospitalization. We excluded patients with initial BG >600mg/dl, decompensated diabetes, stroke, myocardial infarction, pregnancy, or sepsis, and calculated National Early Warning Score to control for illness severity. We examined associations between insulin receipt and hospitalization and mortality in patients with BG 180-600mg/dL using logistic regression, and stratified analyses by diabetes diagnosis and BG value to assess for effect modification.

Results: Of 177,176 eligible patients, 10.9% (19,378) had BG 180-600mg/dL (mean (SD) age=54.6 (15); 52.5% male). Of these patients, 6.8% (1,312) received insulin, 41.8% (8,097) were hospitalized, and 0.3% (278) died. Regression results appear in Figure 1.

Conclusions: Hyperglycemia in the ED was common. Treatment with insulin, though uncommon, yielded lower odds of mortality but not hospitalization. Diabetes diagnosis and severity of hyperglycemia modified this association.


K.Murphy: None. M.E.Lacy: None. K.Heier: None. S.A.Claas: None. J.Keck: None.


National Institutes of Health (UL1TR001998)

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