Hyperglycemia in Young Adults With Types 1 and 2 Diabetes Seen in the Emergency Department: A Health Records Review

Abstract

Patients with diabetes who are in emerging adulthood, defined as the life stage between 18 and 29 years of age, have unique challenges in managing their illness and are at risk for acute complications and loss to follow up. This study's objective was to describe emergency department (ED) utilization because of hyperglycemia in emerging adults with diabetes and to characterize 30-day outcomes, including return visits and admission for hyperglycemia. This was a health-records review of emerging adults presenting over a 1-year period to 4 tertiary care EDs; the patients had known histories of diabetes and final diagnoses of hyperglycemia, diabetic ketoacidosis or hyperosmolar hyperglycemia. Research personnel collected data concerning patients' characteristics, treatments and dispositions and determined whether the patients returned to the ED because of hyperglycemia within 30 days. Descriptive statistics were used to summarize the data where appropriate. There were 160 ED encounters for hyperglycemia, representing 91 unique emerging-adult patients. Mean (SD) age was 23 (3.6) years, and 52.7% were female; 80 (87.9%) had known type 1 diabetes, and 11 (12.1%) had type 2 diabetes. Of 160 visits, 84 (52.5%) resulted in hospital admission; 54 (33.8%) returned to the ED because of hyperglycemia within 30 days of their initial encounters and 20 (12.5%) were admitted on the subsequent visit. We characterized ED use and 30-day outcomes of emerging adults with diabetes and hyperglycemia. Future research should focus on earlier identification of those at higher risk for recurrent ED visits or admission and on the efficacy of interventions to prevent these adverse outcomes.

Keywords: diabetes mellitus; diabète sucré; début de l'âge adulte; emergency department; hyperglycemia; hyperglycémie; patient outcomes; périodes de transition; service des urgences; transition periods; young adulthood; évolution de l'état de santé du patient.