TY - JOUR 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 DO - 10.1136/bmjdrc-2015-000191 VL - 4 IS - 1 SP - e000191 AU - Tien-Ming Hng AU - Amanda Hor AU - Sumathy Ravi AU - Xiaoqi Feng AU - Jaime Lin AU - Thomas Astell-Burt AU - David Chipps AU - Mark McLean AU - Glen Maberly Y1 - 2016/06/01 UR - http://drc.bmj.com/content/4/1/e000191.abstract N2 - 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. ER -