Pronounced hyperglycemia by itself is a dangerous condition, but it is particularly
dangerous when accompanied by ketoacidosis or a hyperglycemic hyperosmolar state (
1
). The measurement of glycemia is universally available and inexpensive. Glycemia is
often measured in the emergency department (ED); in almost 20% of patients, glucose
concentration in serum is evaluated, and capillary glucose measurement is required
in an additional large number of patients (
2
). Another rationale for measuring glycemia in the ED is the fact that every fourth
patient in the ED has diabetes mellitus (DM) (
3
). Glycemic control (and therefore the target range) are important things to be aware
of in the ED (
2
,
4
,
5
,
6
,
7
,
8
,
9
,
10
,
11
,
12
,
13
,
14
,
15
,
16
,
17
). High serum glucose concentration in the ED is a valid marker of in-hospital morbidity
and mortality (
4
,
5
). Despite the prognostic significance of hyperglycemia in the ED, its management in
the ED is clearly suboptimal (
5
). It may be advantageous to start proper hypoglycemic treatment in the ED because
it results in faster achievement of the glycemic target(s).To read this article in full you will need to make a payment
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- Impact of a Subcutaneous Insulin Protocol in the Emergency Department: Rush Emergency Department Hyperglycemia Intervention (REDHI)Journal of Emergency MedicineVol. 40Issue 5
- PreviewObjective: We evaluated a hyperglycemia treatment protocol for use in the Emergency Department (ED) in patients with diabetes mellitus (DM) before admission to the hospital or discharge home. Methods: Fifty-four consecutive patients with a history of DM and an ED admission blood glucose (BG) > 200 mg/dL were treated with subcutaneous (SQ) insulin aspart every 2 h until BG was < 200 mg/dL. Point-of-care BG was measured immediately on ED admission and every 2 h until discharge home or hospital admission.
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- Preview
- Response to “Should Target Glycemic Range Be Exactly the Same for Patients With Acute Myocardial Infarction Versus Without Diabetes?”Journal of Emergency MedicineVol. 59Issue 2
- PreviewWe read with interest the recent letter by Koracevic regarding the target glycemic range for patients with and without diabetes mellitus (DM) during acute myocardial infarction (MI) (1). We thank the author for his insight into this important and relatively poorly researched area of acute management.
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