Stop Emergency Room Visits for Hyperglycemia Project - District of Columbia (DC)
Stop Emergency Room Visits for Hyperglycemia Project - District of Columbia (DC)
To demonstrate that a focused Emergency Department (ED) intervention for uncontrolled
 hyperglycemia enables safe and effective glycemic management and reduces emergency room
 re-visits. We assessed hypoglycemia BG < 60mg/dL; change in mean blood glucose and A1C, and
 ED revisits for hyperglycemia.
Patients with BG > 200mg/dL presenting to an urban tertiary care hospital ED were enrolled in
 a 4 week prospective intervention with historic self-controls. Subjects returned at 12-72
 hours, 2 and 4 weeks. Diabetes medications (including sulfonylureas, metformin and/or
 insulin) were initiated and/or adjusted at each visit using the intervention algorithm per
 presenting blood glucose and prior diabetes medications. Survival skills self-management
 education and navigation to outpatient services were provided.
Inclusion Criteria:

 -  Age > 18 years

 -  Type 2 Diabetes Mellitus,

 -  random BG > 200 mg/dL,

 -  willing and able to provide informed consent and to participate in diabetes
 self-management education (DSME)

 -  stable for discharge from the ED once hyperglycemia treatment initiated.

 Exclusion Criteria:

 -  type 1 Diabetes Mellitus,

 -  diabetic ketoacidosis or hyperosmolar non-ketotic state,

 -  concomitant treatment with glucocorticoids (other than stable maintenance dose
 therapy),

 -  cognitive or physical impairment preventing participation in DSME

 -  unwillingness or inability to provide consent and/or attend follow-up visits.