Poor glycemic control in diabetic patients seeking care in the ED

We hypothesized that diabetic patients in the emergency department (ED) have poorer glycemic control than patients seeking care at primary care clinics. A convenience sample of hemoglobin A1c (HbA1c) values was gathered retrospectively from the ED, Endocrinology, and Family Medicine Clinics. Results were divided into controlled, poorly controlled, and extremely poorly controlled. The only differing pattern of patients (*P < .01) was in the extremely poorly controlled group consisting of 36% of the ED patients (confidence interval [CI], 29.23-42.69; n = 74) vs 18% of the Endocrinology patients (CI, 13.76-22.53; n = 56) and 19% of the Family Medicine patients (CI, 15.98-22.75; n = 105). A frequency distribution of the ED HbA1c values was bimodal. The first peak represents well-controlled diabetic patients. The second, higher peak comprises a larger number of patients (approximate n = 134, 73% of all 207 ED patients) who have poorer glycemic control. We conclude that a large number of ED diabetic patients have poorer glycemic control than the other clinics.