Silverman Robert A, Schleicher Mackenzie G, Valente Christopher J, Kim Mark, Romanenko Yevgeniy, Schulman Rifka C, Tiberio Allison, Greenblatt Benjamin, Rentala Manju, Salvador-Kelly Annabella V, Kwon Nancy S, Jornsay Donna L
Department of Emergency Medicine, North Shore-LIJ Health System, New Hyde Park, NY, USA.
Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
Diabetes Metab Res Rev. 2016 Jan;32(1):82-6. doi: 10.1002/dmrr.2674. Epub 2015 Aug 18.
The proposed 2015 US Preventive Services Task Force guidelines recommend diabetes screening for individuals ≥45 years or demonstrating other risk factors for dysglycemia. Still, many patients with dysglycemia remain undiagnosed, and opportunities for early intervention are lost.
To test novel approaches for diagnosis using the haemoglobin A1c (HbA1c ) test, we screened adult patients who were admitted to an observation unit from the emergency department with no known history of pre-diabetes or diabetes.
Of 256 subjects, 9% were newly diagnosed with diabetes and 52% were newly diagnosed with pre-diabetes. Of those aged 18-29 years, 33% were newly diagnosed with dysglycemia, while 55% of those aged 30-44 years and 70% of those aged ≥45 years were newly diagnosed with dysglycemia.
Our results suggest that regardless of age, a large proportion of patients in the emergency department observation unit have undiagnosed dysglycemia, an important finding given the large number of observation admissions. Copyright © 2015 John Wiley & Sons, Ltd.
2015年美国预防服务工作组提议的指南建议，对年龄≥45岁或有其他血糖异常风险因素的个体进行糖尿病筛查。然而，许多血糖异常患者仍未被诊断出来，从而错失了早期干预的机会。
为了测试使用糖化血红蛋白（HbA1c）检测进行诊断的新方法，我们对从急诊科收治到观察病房、无已知糖尿病前期或糖尿病病史的成年患者进行了筛查。
在256名受试者中，9%被新诊断为糖尿病，52%被新诊断为糖尿病前期。在18 - 29岁的人群中，33%被新诊断为血糖异常，而在30 - 44岁的人群中这一比例为55%，在年龄≥45岁的人群中为70%。
我们的结果表明，无论年龄大小，急诊科观察病房中有很大一部分患者存在未被诊断的血糖异常，鉴于观察病房收治患者数量众多，这是一项重要发现。版权所有© 2015约翰威立父子有限公司。
