Endocrine Abstracts

It is estimated that up to one third of people with type 2 diabetes may be undiagnosed. The Irish College of General Practitioners (ICGP) and the Health Service Executive (HSE) recommend diabetes screening for (1) all adults with BMI ≥ 25 kg/m2 with one or more additional DM risk factors, and (2) all adults age ≥ 45 years, at least once every 3 years. Every interaction with health care services is a potential opportunity to screen for undiagnosed diabetes. We audited the frequency of glucose measurement amongst patients of age ≥ 45 years attending our Emergency Department (ED) over a 6 day time period. Of 389 patients seen, 192 (49%) had glucose tested and 85 patients (44%) were found to have a blood glucose ≥ 7 mmol/l. Of those who had blood glucose ≥ 7 mmol/l, 65% were known to have diabetes meaning that 35% were potentially undiagnosed. Of patients with a blood glucose ≥ 10 mmol/l, 20 had a known history of diabetes and 4 did not. Among the 55 people with glucose ≥ 7 mmol/lwithout known diabetes, only 3 (5%) were referred to the diabetes service and these did not include any of the 4 without diabetes and with a blood glucose ≥ 10 mmol/l. We conclude that, while it is not the role of the ED to screen for diabetes, it is likely that an opportunity to pick up undiagnosed diabetes and refer patients to specialist services is being missed when glucose is measured.