The Synergy to Control Emergency Department Hyperglycemia Program for Type 2 Diabetes
The Synergy to Control Emergency Department Hyperglycemia Program for Type 2 Diabetes
A 4 week prospective, randomized controlled study was carried out to assess the impact of a
 care delivery intervention which focused on blood glucose (BG) management among adults with
 type 2 diabetes presenting to the Emergency Department (ED) with BG > 200mg/dL (11.1 mmol/L).
 The intervention was designed by a multi-disciplinary team of ED physicians and nurses,
 endocrinologists and diabetes educators. The intervention incorporated three components: a
 guideline-based algorithm for diabetes medication management; survival skills diabetes
 self-management education (DSME); and support for health system navigation. The control group
 received usual care per the ED's policies and procedures for management of high blood
 glucose.
We evaluated a concise diabetes care delivery intervention designed to advance glycemic
 medications and deliver diabetes self-management education (DSME) among adults with type 2
 diabetes presenting to the emergency department (ED) with uncontrolled hyperglycemia. The
 primary hypothesis was that there would be improvement in HbA1c.

 A 4 week, randomized controlled trial provided algorithm-based antihyperglycemic medications
 management, survival skills DSME and navigation to primary care for ED patients with BG >
 200mg/dL. Medications were titrated and DSME delivered by endocrinologist-supervised
 certified diabetes educators. Controls received usual care.
Inclusion Criteria:

 -  A new or existing diagnosis of type 2 diabetes;

 -  BG > 200 mg/dl in the ED;

 -  age >/= 18 years;

 -  willing and able to check BG and self-inject insulin, if required and otherwise stable
 for discharge to the outpatient setting.

 Exclusion Criteria:

 -  type 1 diabetes and other specific types of diabetes per the American Diabetes
 Association Position Statement on the Classification of Diabetes Mellitus,

 -  pregnancy or anticipated conception in the next 3 months;

 -  treatment with a glucocorticoid, unless at a stable physiologic replacement dose; or

 -  a history of diabetic ketoacidosis.