RT Journal Article SR Electronic T1 Diabetes case finding in the emergency department, using HbA1c: an opportunity to improve diabetes detection, prevention, and care JF BMJ Open Diabetes Research & Care JO BMJ Open Diab Res Care FD American Diabetes Association SP e000191 DO 10.1136/bmjdrc-2015-000191 VO 4 IS 1 A1 Tien-Ming Hng A1 Amanda Hor A1 Sumathy Ravi A1 Xiaoqi Feng A1 Jaime Lin A1 Thomas Astell-Burt A1 David Chipps A1 Mark McLean A1 Glen Maberly YR 2016 UL http://drc.bmj.com/content/4/1/e000191.abstract AB Objective We assessed the efficacy of routine glycated hemoglobin (HbA1c) testing to detect undiagnosed diabetes and prediabetes in an urban Australian public hospital emergency department (ED) located in an area of high diabetes prevalence.Methods Over 6 weeks, all patients undergoing blood sampling in the ED had their random blood glucose measured. If ≥5.5 mmol/L (99 mg/dL), HbA1c was measured on the same sample. HbA1c levels ≥6.5% (48 mmol/mol) and 5.7–6.4% (39–46 mmol/mol) were diagnostic of diabetes and prediabetes, respectively. Hospital records were reviewed to identify patients with previously diagnosed diabetes.Results Among 4580 presentations, 2652 had blood sampled of which 1267 samples had HbA1c measured. Of these, 487 (38.4%) had diabetes (either HbA1c≥6.5% or a prior diagnosis), and a further 347 (27.4%) had prediabetes. Among those with diabetes, 32.2% were previously undiagnosed.Conclusions Routine HbA1c testing in the ED identifies a large number of people with undiagnosed diabetes and prediabetes, and provides an opportunity to improve their care.