STEP-DC: Stop Emergency Room Visits for Uncontrolled Hyperglycemia Project in the District of Columbia
概览
- 阶段
- 不适用
- 干预措施
- Antihyperglycemic medication guideline for management of uncontrolled hyperglycemia presenting to the ED using metformin, sulfonylurea and/or insulin
- 疾病 / 适应症
- Type 2 Diabetes Mellitus
- 发起方
- Medstar Health Research Institute
- 入组人数
- 86
- 试验地点
- 1
- 主要终点
- Total Number of Hypoglycemia Events (Blood Glucose < 60mg/dL) Within 24 Hours of Baseline Visit
- 状态
- 已完成
- 最后更新
- 5年前
概览
简要总结
To demonstrate that a focused Emergency Department (ED) intervention for uncontrolled hyperglycemia enables safe and effective glycemic management and reduces emergency room re-visits. We assessed hypoglycemia BG < 60mg/dL; change in mean blood glucose and A1C, and ED revisits for hyperglycemia.
详细描述
Patients with BG \> 200mg/dL presenting to an urban tertiary care hospital ED were enrolled in a 4 week prospective intervention with historic self-controls. Subjects returned at 12-72 hours, 2 and 4 weeks. Diabetes medications (including sulfonylureas, metformin and/or insulin) were initiated and/or adjusted at each visit using the intervention algorithm per presenting blood glucose and prior diabetes medications. Survival skills self-management education and navigation to outpatient services were provided.
研究者
Michelle Magee
Director, MedStar Diabetes Institute
Medstar Health Research Institute
入排标准
入选标准
- •Age \> 18 years
- •Type 2 Diabetes Mellitus,
- •random BG \> 200 mg/dL,
- •willing and able to provide informed consent and to participate in diabetes self-management education (DSME)
- •stable for discharge from the ED once hyperglycemia treatment initiated.
排除标准
- •type 1 Diabetes Mellitus,
- •diabetic ketoacidosis or hyperosmolar non-ketotic state,
- •concomitant treatment with glucocorticoids (other than stable maintenance dose therapy),
- •cognitive or physical impairment preventing participation in DSME
- •unwillingness or inability to provide consent and/or attend follow-up visits.
研究组 & 干预措施
Diabetes education and medication management
All enrolled patients received the intervention. There was no comparative arm. The analysis was done as pre and post.
干预措施: Antihyperglycemic medication guideline for management of uncontrolled hyperglycemia presenting to the ED using metformin, sulfonylurea and/or insulin
Diabetes education and medication management
All enrolled patients received the intervention. There was no comparative arm. The analysis was done as pre and post.
干预措施: Diabetes survival skills self-management education
结局指标
主要结局
Total Number of Hypoglycemia Events (Blood Glucose < 60mg/dL) Within 24 Hours of Baseline Visit
时间窗: 24 hours
Total Number of hypoglycemic events defined as Blood Glucose \< 60 within 24 hours of index emergency room visit (baseline)
次要结局
- Change in Hemoglobin A1C From Baseline to End of Intervention at 30 Days(30 days)
- Change in Mean Blood Glucose From Time of Presentation to Emergency Room to End of Intervention 30 Days From Baseline(30 days)