[ { "key": "JTKSMVJT", "version": 2, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/JTKSMVJT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/JTKSMVJT", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/93288/items/EGSXTZ3K", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "JTKSMVJT", "version": 2, "parentItem": "EGSXTZ3K", "itemType": "attachment", "linkMode": "imported_url", "title": "PubMed Central Full Text PDF", "accessDate": "2012-10-12T11:35:56Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144771/pdf/13300_2011_Article_1.pdf", "note": "", "contentType": "application/pdf", "charset": "", "filename": "Armor et al. - 2011 - Assessment of the clinical outcome of a symptom-ba.pdf", "md5": "a77c0a530b82375a7baebcb77701dc6c", "mtime": 1350041757172, "tags": [], "relations": {}, "dateAdded": "2012-10-12T11:35:56Z", "dateModified": "2012-10-12T11:35:58Z" } }, { "key": "ZMWP746P", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/ZMWP746P", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/ZMWP746P", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/93288/items/EGSXTZ3K", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } } }, "data": { "key": "ZMWP746P", "version": 1, "parentItem": "EGSXTZ3K", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Link", "accessDate": "2012-10-12T11:35:56Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144771/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2012-10-12T11:35:56Z", "dateModified": "2012-10-12T11:35:56Z" } }, { "key": "EGSXTZ3K", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/EGSXTZ3K", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/EGSXTZ3K", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Armor et al.", "parsedDate": "2011-05", "numChildren": 2 }, "data": { "key": "EGSXTZ3K", "version": 1, "itemType": "journalArticle", "title": "Assessment of the clinical outcome of a symptom-based outpatient hyperglycemia protocol", "creators": [ { "creatorType": "author", "firstName": "Becky", "lastName": "Armor" }, { "creatorType": "author", "firstName": "Don", "lastName": "Harrison" }, { "creatorType": "author", "firstName": "Frank", "lastName": "Lawler" } ], "abstractNote": "Introduction\nAcute hyperglycemia (blood glucose [BG] ≥400 mg/dL) is common in primary care. An outpatient protocol was developed to streamline the treatment of acute hyperglycemia. The objective was to determine if an outpatient hyperglycemia protocol could achieve a BG level of <300 mg/dL within 4 hours.\n\nMethods\nAdult diabetic patients with acute symptomatic hyperglycemia (>400 mg/dL) without acute illness were recruited. Enrolled patients were managed with a protocol that included administration of 0.15 units/kg rapid-acting insulin given subcutaneously, hydration, hourly fingerstick blood sugars (FSBS), laboratory assessment, tailored diabetes education, and follow-up within 72 hours. Independent variables for data analysis included age, baseline FSBS, sodium, potassium, chloride, blood urea nitrogen, serum creatinine, CO2, venous glucose, and etiology (medications, diet, personal stress).\n\nResults\nFor the 27 patients enrolled, the average initial FSBS level (n=23) was 484 mg/dL, the average final FSBS level (n=27) was 274 mg/dL, and average time to achieve BG levels of <300 mg/dL was 2.35 hours. The protocol was successful in 20 patients (74%). The causes for seven protocol failures were nonclinical in nature. The patients’ weight and total time to goal were significantly associated with odds of protocol success. Personal stress significantly correlated with protocol failure. The protocol success group had a higher sodium level than the failure group (P=0.01). Weight and baseline BG showed decreased odds of protocol success (P=0.05 and P=0.04, respectively).\n\nConclusions\nResults of this pilot study suggest acute hyperglycemia without other acute illness can be managed on an outpatient basis. Outpatient interventions to addres s acute hyperglycemia need further investigation. Managing acute hyperglycemia in the outpatient setting could potentially decrease hospital admissions for hyperglycemic hyperosmolar syndrome and mild diabetic ketoacidosis.\n\nElectronic Supplementary Material\nSupplementary material is available for this article at 10.1007/s13300-011-0001-4 and is accessible for authorized users.", "publicationTitle": "Diabetes Therapy", "publisher": "", "place": "", "date": "2011-5", "volume": "2", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "67-80", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Diabetes Ther", "DOI": "10.1007/s13300-011-0001-4", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144771/", "accessDate": "2012-10-12T11:35:56Z", "PMID": "", "PMCID": "", "ISSN": "1869-6953", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 22127801\nPMCID: PMC3144771", "tags": [], "collections": [ "85JCZTBV" ], "relations": {}, "dateAdded": "2012-10-12T11:35:56Z", "dateModified": "2012-10-12T11:35:56Z" } }, { "key": "3STCEE3S", "version": 2, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/3STCEE3S", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/3STCEE3S", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/93288/items/SIGK3XTP", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } } }, "data": { "key": "3STCEE3S", "version": 2, "parentItem": "SIGK3XTP", "itemType": "attachment", "linkMode": "imported_url", "title": "Snapshot", "accessDate": "2012-10-05T17:59:58Z", "url": "http://www.cdc.gov/nchs/fastats/diabetes.htm", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "diabetes.html", "md5": "1db00b8c1b3256a083bf7588df4f791d", "mtime": 1349459998888, "tags": [], "relations": {}, "dateAdded": "2012-10-05T17:59:58Z", "dateModified": "2012-10-05T17:59:58Z" } }, { "key": "SIGK3XTP", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/SIGK3XTP", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/SIGK3XTP", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "numChildren": 1 }, "data": { "key": "SIGK3XTP", "version": 1, "itemType": "webpage", "title": "FASTSTATS - 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2002 - Hyperglycemia An Independent Marker of In-Hospita.pdf", "md5": "e5861a1a490e8bb0577eb72462e4f9bb", "mtime": 1349444715967, "tags": [], "relations": {}, "dateAdded": "2012-10-05T13:45:14Z", "dateModified": "2012-10-05T13:45:15Z" } }, { "key": "PEMF45J6", "version": 2, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/PEMF45J6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/PEMF45J6", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/93288/items/JFA7PGWT", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } } }, "data": { "key": "PEMF45J6", "version": 2, "parentItem": "JFA7PGWT", "itemType": "attachment", "linkMode": "imported_url", "title": "Snapshot", "accessDate": "2012-10-05T13:45:14Z", "url": "http://jcem.endojournals.org/content/87/3/978.abstract?ijkey=8e280aa342d1120f20ec17a86fd8860e2358454f&keytype2=tf_ipsecsha", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "978.html", "md5": "ab8e9942b582ba548b238792c50b8620", "mtime": 1349444714764, "tags": [], "relations": {}, "dateAdded": "2012-10-05T13:45:14Z", "dateModified": "2012-10-05T13:45:14Z" } }, { "key": "JFA7PGWT", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/JFA7PGWT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/JFA7PGWT", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Umpierrez et al.", "parsedDate": "2002-03-01", "numChildren": 2 }, "data": { "key": "JFA7PGWT", "version": 1, "itemType": "journalArticle", "title": "Hyperglycemia: An Independent Marker of In-Hospital Mortality in Patients with Undiagnosed Diabetes", "creators": [ { "creatorType": "author", "firstName": "Guillermo E.", "lastName": "Umpierrez" }, { "creatorType": "author", "firstName": "Scott D.", "lastName": "Isaacs" }, { "creatorType": "author", "firstName": "Niloofar", "lastName": "Bazargan" }, { "creatorType": "author", "firstName": "Xiangdong", "lastName": "You" }, { "creatorType": "author", "firstName": "Leonard M.", "lastName": "Thaler" }, { "creatorType": "author", "firstName": "Abbas E.", "lastName": "Kitabchi" } ], "abstractNote": "Admission hyperglycemia has been associated with increased hospital mortality in critically ill patients; however, it is not known whether hyperglycemia in patients admitted to general hospital wards is associated with poor outcome. The aim of this study was to determine the prevalence of in-hospital hyperglycemia and determine the survival and functional outcome of patients with hyperglycemia with and without a history of diabetes. We reviewed the medical records of 2030 consecutive adult patients admitted to Georgia Baptist Medical Center, a community teaching hospital in downtown Atlanta, GA, from July 1, 1998, to October 20, 1998. New hyperglycemia was defined as an admission or in-hospital fasting glucose level of 126 mg/dl (7 mmol/liter) or more or a random blood glucose level of 200 mg/dl (11.1 mmol/liter) or more on 2 or more determinations. Hyperglycemia was present in 38% of patients admitted to the hospital, of whom 26% had a known history of diabetes, and 12% had no history of diabetes before the admission. Newly discovered hyperglycemia was associated with higher in-hospital mortality rate (16%) compared with those patients with a prior history of diabetes (3%) and subjects with normoglycemia (1.7%; both P < 0.01). In addition, new hyperglycemic patients had a longer length of hospital stay, a higher admission rate to an intensive care unit, and were less likely to be discharged to home, frequently requiring transfer to a transitional care unit or nursing home facility.\nOur results indicate that in-hospital hyperglycemia is a common finding and represents an important marker of poor clinical outcome and mortality in patients with and without a history of diabetes. Patients with newly diagnosed hyperglycemia had a significantly higher mortality rate and a lower functional outcome than patients with a known history of diabetes or normoglycemia.", "publicationTitle": "Journal of Clinical Endocrinology & Metabolism", "publisher": "", "place": "", "date": "03/01/2002", "volume": "87", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "978-982", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "JCEM", "DOI": "10.1210/jc.87.3.978", "citationKey": "", "url": "http://jcem.endojournals.org/content/87/3/978", "accessDate": "2012-10-05T13:45:14Z", "PMID": "", "PMCID": "", "ISSN": "0021-972X, 1945-7197", "archive": "", "archiveLocation": "", "shortTitle": "Hyperglycemia", "language": "en", "libraryCatalog": "jcem.endojournals.org", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "4DQHQTVB" ], "relations": {}, "dateAdded": "2012-10-05T13:45:14Z", "dateModified": "2012-10-05T13:45:14Z" } }, { "key": "GRMF4WN5", "version": 3, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/GRMF4WN5", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/GRMF4WN5", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Magee and Nassar", "parsedDate": "2011-11", "numChildren": 1 }, "data": { "key": "GRMF4WN5", "version": 3, "itemType": "journalArticle", "title": "Hemoglobin A1c testing in an emergency department", "creators": [ { "creatorType": "author", "firstName": "Michelle F", "lastName": "Magee" }, { "creatorType": "author", "firstName": "Carine", "lastName": "Nassar" } ], "abstractNote": "BACKGROUND\n\nEmergency department (ED) visits for hyperglycemia are common and costly. Enhanced strategies for recognizing and managing patients with diabetes in the ED are needed. Hemoglobin A1c (A1C) testing is typically used to assess level of glycemic control in the 2-3 months preceding an office visit. In this article, we report on potential roles for point-of-care (POC) A1C testing in the ED for patients presenting with uncontrolled hyperglycemia.\n\n\nMETHODS\n\nWe enrolled patients presenting to an urban tertiary care hospital ED with blood glucose (BG) ≥ 200 mg/dl who were otherwise stable for discharge (n = 86) in a prospective, nonrandomized pilot study. Antihyperglycemic medication management, survival-skills diabetes self-management education, and health system navigation were provided. Followup visits took place at 24-72 hours and at 2 and 4 weeks. Point-of-care A1C testing was performed at baseline and at 2 weeks. Baseline A1C results were used by the ED physician and the educator to inform the patient of likely preadmission glycemic classification, and the potential role that the (diabetes mellitus) DM medication regimen assigned in the ED had in enabling overall progress in glycemic control at 2 weeks post-ED initiation of treatment.\n\n\nRESULTS\n\nAt baseline, 50% of POC A1C values were >13%. Mean BG fell from 356 ± 110 mg/dl to 183 ± 103 mg/dl at 4 weeks (average decrease of 173.5 g/dl, p < 0.001). Mean A1C fell by 0.4%, from 12.0 ± 1.5% to 11.6 ± 1.6% at 2 weeks, p = 0.048. There were zero instances of day 1 hypoglycemia and overall hypoglycemia rates were low (1.3%).\n\n\nCONCLUSIONS\n\nPoint-of-care A1C testing in the ED helped inform both the provider and the patient of likely prior glycemic status, including unrecognized or uncontrolled type 2 diabetes, and allowed emphasis of the importance of timely diabetes self-management education and medication management in preventing acute and chronic complications. Followup POC A1C testing at 2 weeks was used to confirm early improvement in glycemic control postintervention.", "publicationTitle": "Journal of diabetes science and technology", "publisher": "", "place": "", "date": "Nov 2011", "volume": "5", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "1437-1443", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Diabetes Sci Technol", "DOI": "", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1932-2968", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22226261", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Algorithms", "type": 1 }, { "tag": "Blood Glucose", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Emergency Service, Hospital", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Pilot Projects", "type": 1 }, { "tag": "Point-of-Care Systems", "type": 1 } ], "collections": [ "RJPQFFT9" ], "relations": {}, "dateAdded": "2012-10-04T17:09:55Z", "dateModified": "2012-10-05T13:03:40Z" } }, { "key": "2MBV2X64", "version": 2, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/2MBV2X64", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/2MBV2X64", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Ginde et al.", "parsedDate": "2008-12", "numChildren": 1 }, "data": { "key": "2MBV2X64", "version": 2, "itemType": "journalArticle", "title": "Point-of-care glucose and hemoglobin A1c in emergency department patients without known diabetes: implications for opportunistic screening", "creators": [ { "creatorType": "author", "firstName": "Adit A", "lastName": "Ginde" }, { "creatorType": "author", "firstName": "Enrico", "lastName": "Cagliero" }, { "creatorType": "author", "firstName": "David M", "lastName": "Nathan" }, { "creatorType": "author", "firstName": "Carlos A, Jr", "lastName": "Camargo" } ], "abstractNote": "OBJECTIVES\n\nThe objectives were to evaluate the correlation between random glucose and hemoglobin A1c (HbA1c) in emergency department (ED) patients without known diabetes and to determine the ability of diabetes screening in the ED to predict outpatient diabetes.\n\n\nMETHODS\n\nThis was a cross-sectional study at an urban academic ED. The authors enrolled consecutive adult patients without known diabetes during eight 24-hour periods. Point-of-care (POC) random capillary glucose and HbA1c levels were tested, as well as laboratory HbA1c in a subset of patients. Participants with HbA1c > or = 6.1% were scheduled for oral glucose tolerance test (OGTT).\n\n\nRESULTS\n\nThe 265 enrolled patients were 47% female and 80% white, with a median age of 42 years. Median glucose and HbA1c levels were 93 mg/dL (interquartile range [IQR] = 82-108) and 5.8% (IQR = 5.5-6.2), respectively. The correlation between POC and laboratory HbA1c was r = 0.96, with mean difference 0.33% (95% confidence interval [CI] = 0.27% to 0.39%). Glucose threshold > or = 120 mg/dL had 89% specificity and 26% sensitivity for predicting the 76 (29%) patients with abnormal HbA1c; > or = 140 mg/dL had 98% specificity and 14% sensitivity. The correlation between random glucose and HbA1c was moderate (r = 0.60) and was affected by age, gender, prandial status, corticosteroid use, and current injury. Only 38% of participants with abnormal HbA1c returned for OGTTs; 38% had diabetes, 34% had impaired fasting glucose/impaired glucose tolerance, and 28% had normal glucose tolerance.\n\n\nCONCLUSIONS\n\nED patients have a high prevalence of undiagnosed diabetes. Although screening with POC random glucose and HbA1c is promising, improvement in follow-up with confirmatory testing and initiation of treatment is needed before opportunistic ED screening can be recommended.", "publicationTitle": "Academic emergency medicine: official journal of the Society for Academic Emergency Medicine", "publisher": "", "place": "", "date": "Dec 2008", "volume": "15", "issue": "12", "section": "", "partNumber": "", "partTitle": "", "pages": "1241-1247", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Acad Emerg Med", "DOI": "10.1111/j.1553-2712.2008.00240.x", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1553-2712", "archive": "", "archiveLocation": "", "shortTitle": "Point-of-care glucose and hemoglobin A1c in emergency department patients without known diabetes", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18785943", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Age Distribution", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Blood Glucose", "type": 1 }, { "tag": "Body Mass Index", "type": 1 }, { "tag": "Boston", "type": 1 }, { "tag": "Continental Population Groups", "type": 1 }, { "tag": "Cross-Sectional Studies", "type": 1 }, { "tag": "Diabetes Mellitus", "type": 1 }, { "tag": "Emergency Service, Hospital", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Glucose Tolerance Test", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Mass Screening", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Multivariate Analysis", "type": 1 }, { "tag": "Point-of-Care Systems", "type": 1 }, { "tag": "Socioeconomic Factors", "type": 1 }, { "tag": "Statistics as Topic", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [ "RJPQFFT9" ], "relations": {}, "dateAdded": "2012-10-04T17:12:00Z", "dateModified": "2012-10-05T13:03:40Z" } }, { "key": "VZFU7N4T", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/VZFU7N4T", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/VZFU7N4T", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Saudek et al.", "parsedDate": "2008-07", "numChildren": 1 }, "data": { "key": "VZFU7N4T", "version": 1, "itemType": "journalArticle", "title": "A new look at screening and diagnosing diabetes mellitus", "creators": [ { "creatorType": "author", "firstName": "Christopher D", "lastName": "Saudek" }, { "creatorType": "author", "firstName": "William H", "lastName": "Herman" }, { "creatorType": "author", "firstName": "David B", "lastName": "Sacks" }, { "creatorType": "author", "firstName": "Richard M", "lastName": "Bergenstal" }, { "creatorType": "author", "firstName": "David", "lastName": "Edelman" }, { "creatorType": "author", "firstName": "Mayer B", "lastName": "Davidson" } ], "abstractNote": "OBJECTIVE\n\nDiabetes is underdiagnosed. About one third of people with diabetes do not know they have it, and the average lag between onset and diagnosis is 7 yr. This report reconsiders the criteria for diagnosing diabetes and recommends screening criteria to make case finding easier for clinicians and patients.\n\n\nPARTICIPANTS\n\nR.M.B. invited experts in the area of diagnosis, monitoring, and management of diabetes to form a panel to review the literature and develop consensus regarding the screening and diagnosis of diabetes with particular reference to the use of hemoglobin A1c (HbA1c). Participants met in open session and by E-mail thereafter. Metrika, Inc. sponsored the meeting.\n\n\nEVIDENCE\n\nA literature search was performed using standard search engines.\n\n\nCONSENSUS PROCESS\n\nThe panel heard each member's discussion of the issues, reviewing evidence prior to drafting conclusions. Principal conclusions were agreed on, and then specific cut points were discussed in an iterative consensus process.\n\n\nCONCLUSIONS\n\nThe main factors in support of using HbA1c as a screening and diagnostic test include: 1) HbA1c does not require patients to be fasting; 2) HbA1c reflects longer-term glycemia than does plasma glucose; 3) HbA1c laboratory methods are now well standardized and reliable; and 4) errors caused by nonglycemic factors affecting HbA1c such as hemoglobinopathies are infrequent and can be minimized by confirming the diagnosis of diabetes with a plasma glucose (PG)-specific test. Specific recommendations include: 1) screening standards should be established that prompt further testing and closer follow-up, including fasting PG of 100 mg/dl or greater, random PG of 130 mg/dl or greater, or HbA1c greater than 6.0%; 2) HbA1c of 6.5-6.9% or greater, confirmed by a PG-specific test (fasting plasma glucose or oral glucose tolerance test), should establish the diagnosis of diabetes; and 3) HbA1c of 7% or greater, confirmed by another HbA1c- or a PG-specific test (fasting plasma glucose or oral glucose tolerance test) should establish the diagnosis of diabetes. The recommendations are offered for consideration of the clinical community and interested associations and societies.", "publicationTitle": "The Journal of clinical endocrinology and metabolism", "publisher": "", "place": "", "date": "Jul 2008", "volume": "93", "issue": "7", "section": "", "partNumber": "", "partTitle": "", "pages": "2447-2453", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J. Clin. Endocrinol. Metab.", "DOI": "10.1210/jc.2007-2174", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "0021-972X", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 18460560", "tags": [ { "tag": "Blood Glucose", "type": 1 }, { "tag": "Diabetes Mellitus", "type": 1 }, { "tag": "Glucose Tolerance Test", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Sensitivity and Specificity", "type": 1 } ], "collections": [ "RJPQFFT9" ], "relations": {}, "dateAdded": "2012-10-04T17:13:05Z", "dateModified": "2012-10-05T13:03:40Z" } }, { "key": "MSFZPB4P", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/MSFZPB4P", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/MSFZPB4P", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/93288/items/EKBTRAMD", "type": "application/json" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } } }, "data": { "key": "MSFZPB4P", "version": 1, "parentItem": "EKBTRAMD", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Link", "accessDate": "2012-10-05T13:03:23Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/19140193", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2012-10-05T13:03:23Z", "dateModified": "2012-10-05T13:03:23Z" } }, { "key": "EKBTRAMD", "version": 1, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/EKBTRAMD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/EKBTRAMD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Ginde et al.", "parsedDate": "2009-01", "numChildren": 1 }, "data": { "key": "EKBTRAMD", "version": 1, "itemType": "journalArticle", "title": "Limited communication and management of emergency department hyperglycemia in hospitalized patients", "creators": [ { "creatorType": "author", "firstName": "Adit A", "lastName": "Ginde" }, { "creatorType": "author", "firstName": "Davut J", "lastName": "Savaser" }, { "creatorType": "author", "firstName": "Carlos A, Jr", "lastName": "Camargo" } ], "abstractNote": "BACKGROUND\n\nHyperglycemia is often overlooked and unaddressed in hospitalized patients, and early and intensive management may improve outcomes.\n\n\nOBJECTIVE\n\nTo evaluate communication and early management of emergency department (ED) hyperglycemia.\n\n\nMETHODS\n\nThis was a retrospective cohort study of patients with an initial serum glucose >or=140 mg/dL at an urban, academic institution. We randomly selected cases from a consecutive sample of ED visits with at least 1 serum glucose result during a 1-year period. We recorded clinical data and compared the content of inpatient and ED-written discharge instructions.\n\n\nRESULTS\n\nOf the 27,688 initial ED glucose results during the study period, 3517 (13%) were 140-199 mg/dL, and 2304 (8%) values were >or=200 mg/dL. In our sample of 385 patients, 293 (76%) patients were hospitalized. Inpatient or ED discharge instructions informed 36 (10%) patients of their hyperglycemia and 23 (6%) of a plan for further evaluation and management. There was no difference between inpatient and ED instructions for either of these variables (P = 0.73 and 0.16, respectively). Overall, 107 (55%) patients with glucose values 140-199 mg/dL and 31 (16%) patients with glucose >or=200 mg/dL had no prior diabetes diagnosis. Only 61 (16%) received insulin in the ED for their hyperglycemia, and hyperglycemia was charted as a diagnosis in 36 (9%) cases.\n\n\nCONCLUSIONS\n\nMost ED patients with even mild hyperglycemia were hospitalized. Recognition, communication, and management of ED hyperglycemia were suboptimal and represent a missed opportunity to identify undiagnosed diabetes and to initiate early glycemic control for hospitalized patients.", "publicationTitle": "Journal of hospital medicine: an official publication of the Society of Hospital Medicine", "publisher": "", "place": "", "date": "Jan 2009", "volume": "4", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "45-49", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Hosp Med", "DOI": "10.1002/jhm.400", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1553-5606", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 19140193", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Cohort Studies", "type": 1 }, { "tag": "Communication", "type": 1 }, { "tag": "Disease Management", "type": 1 }, { "tag": "Emergency Service, Hospital", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Hospitalization", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hyperglycemia", "type": 1 }, { "tag": "Insulin", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Physician-Patient Relations", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 } ], "collections": [ "4DQHQTVB" ], "relations": {}, "dateAdded": "2012-10-05T13:03:23Z", "dateModified": "2012-10-05T13:03:23Z" } }, { "key": "V6XT2WNQ", "version": 2, "library": { "type": "group", "id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/V6XT2WNQ", "type": "application/json" }, "alternate": { "href": 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"id": 93288, "name": "Diabetes ED Care", "links": { "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/93288/items/CKNXA63E", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/diabetes_ed_care/items/CKNXA63E", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "CDC", "numChildren": 1 }, "data": { "key": "CKNXA63E", "version": 1, "itemType": "webpage", "title": "CDC's Diabetes Program - Data & Trends - Death Rates for Hyperglycemic Crises as Underlying Cause per 100,000 Diabetic Population, Males, by Age, United States, 1980-2009", "creators": [ { "creatorType": "author", "firstName": "", "lastName": "CDC" } ], "abstractNote": "U.S. data and charts for visual impairment among individuals with diabetes, collected by the National Diabetes Surveillance System, within the CDC Division of Diabetes Translation.", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.cdc.gov/diabetes/statistics/mortalitydka/tRateDKAMalesDiabPopByAge.htm", "accessDate": "2012-10-05T12:32:08Z", "shortTitle": "", "language": "en-US", "rights": "", "extra": "Prevalence of Diabetes", "tags": [ { "tag": "000 Diabetic Population", "type": 1 }, { "tag": "1980-2009", "type": 1 }, { "tag": "CDC's Diabetes Program - Data & Trends - Death Rates for Hyperglycemic Crises as Underlying Cause per 100", "type": 1 }, { "tag": "Males", "type": 1 }, { "tag": "United States", "type": 1 }, { "tag": "by Age", "type": 1 } ], "collections": [ "4DQHQTVB" ], "relations": {}, "dateAdded": "2012-10-05T12:32:08Z", "dateModified": "2012-10-05T12:32:08Z" } }, { "key": "IDRSWHT9", "version": 2, "library": { "type": "group", "id": 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