Management of Hyperglycemia and Diabetes in the Emergency Department

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Hyperglycemia in the emergency department (ED) is being recognized as a public health problem and presents a clinical challenge. This review critically summarizes available evidence on the burden, etiology, diagnosis, and practical management strategies for hyperglycemia in the ED. Recent Findings: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies that commonly present to the ED. However, the most common form of hyperglycemia in ED is associated with non-hyperglycemic medical emergencies. The presence of hyperglycemia increases the mortality and morbidity associated with the primary condition. The related hospital admission rates and costs are also elevated. The frequency of DKA or HHS related mortality and morbidity has remained high over the last decade. However, attempts have been made to improve management of all hyperglycemia in the ED. Evidence suggests that better management of hyperglycemia in the ED with proper follow-up improves clinical outcomes and prevents readmission. Summary: Optimization of the hyperglycemia management in the ED may improve clinical outcomes. However, more clinical trial data on the outcomes and cost-effectiveness of various management strategies or protocols are needed.

Original languageEnglish (US)
Article number56
JournalCurrent Diabetes Reports
Volume17
Issue number8
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Keywords

  • Diabetes
  • Diabetic ketoacidosis
  • Emergency department
  • Hyperglycemia
  • Hyperglycemic hyperosmolar state

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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