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Type 2

Screening for Type 2 Diabetes in the Emergency Department

In the US, it is estimated that 8.5 million people are unaware that they have T2D, which can lead to serious health problems. A new research project addressed this problem by implementing diabetes screenings as part of emergency department visits.

Urban emergency departments (EDs) are a common source of primary care for racial and ethnic minorities and underserved patients, populations that have the highest rates of type 2 diabetes. While EDs have successfully screened for health issues such as HIV and substance abuse, there have been few short-term studies on ED screening for T2D, and no study has developed a daily screening program for T2D in underserved populations.

To address this issue, a T2D screening program was developed and piloted in a Chicago, Illinois, ED from February 1 to April 30, 2021. The program flagged ED patients at risk for T2D. Screenings were based on American Diabetes Association guidelines, which recommended an A1C test for anyone over 45 or those who were 18-44 with a body mass index (BMI) of 25 or higher. Patients were contacted to provide A1C results and to inquire about their T2D diagnosis and treatment.

The results of the pilot study showed that out of the 8,441 people admitted to the emergency department, 2,576 were flagged by the alert and 2,074 of those people were given an A1C test. 

52% of these patients had an abnormal A1C result, with 70% having prediabetes and 30% having T2D. The study also found that a significant number of patients with undiagnosed T2D or prediabetes were racial and ethnic minorities and low-income patients. Another interesting outcome of this study was that it identified people who had previously been diagnosed with T2D but were not receiving treatment for their condition.

This study highlights the need for further research and implementation of T2D screening programs in urban EDs to help identify and treat patients with undiagnosed T2D or prediabetes, particularly those from underserved communities.

To learn more about diabetes screening and care in under-resourced communities, read our other articles: