Stop Emergency Room Visits for Hyperglycemia Project - District of Columbia (DC) (STEP-DC)

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MedStar Health

Status

Completed

Conditions

Type 2 Diabetes Mellitus

Treatments

Drug: Antihyperglycemic medication guideline for management of uncontrolled hyperglycemia presenting to the ED using metformin, sulfonylurea and/or insulin
Behavioral: Diabetes survival skills self-management education

Study type

Interventional

Funder types

Other

Identifiers

NCT01033773
2007-268

Details and patient eligibility

About

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.

Full description

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.

Enrollment

86 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • 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.

Exclusion criteria

  • 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.

Trial design

Primary purpose

Treatment

Allocation

N/A

Interventional model

Single Group Assignment

Masking

None (Open label)

86 participants in 1 patient group

Diabetes education and medication management
Other group
Description:
All enrolled patients received the intervention. There was no comparative arm. The analysis was done as pre and post.
Treatment:
Behavioral: Diabetes survival skills self-management education
Drug: Antihyperglycemic medication guideline for management of uncontrolled hyperglycemia presenting to the ED using metformin, sulfonylurea and/or insulin

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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