Diabetes Management in Emergency Care Systems
Summary
Emergency care systems play an increasingly vital role in the identification, evaluation and initial treatment of patients with diabetes. Rapid assessment of blood glucose levels, use of point-of-care HbA1c testing and risk stratification protocols enable emergency clinicians to detect undiagnosed diabetes and flag poorly controlled disease. Standardised pathways for managing acute complications—such as diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS)—combine fluid resuscitation, insulin administration and electrolyte correction. Beyond acute interventions, many emergency departments (EDs) now integrate referral schemes into community-based disease management programmes, supported by electronic health record alerts and multidisciplinary follow-up arrangements. These initiatives aim to reduce unplanned revisits, improve long-term glycaemic control and address health disparities by reaching under-served populations at the point of care.
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Diabetes Management in Emergency Care Systems publication trend
The graph below shows the total number of articles in diabetes management in emergency care systems across all publications each year (not limited to Nature Index journals).
Technical terms
Emergency department (ED): A hospital unit providing rapid assessment and treatment of acute medical conditions.
Haemoglobin A1c (HbA1c): A measure of average blood glucose over the previous two to three months.
Hyperglycaemia: Elevated blood glucose concentration, often defined as a plasma glucose > 10 mmol/L (180 mg/dL).
Diabetic ketoacidosis (DKA): Acute complication characterised by hyperglycaemia, ketonaemia and metabolic acidosis.
Hyperosmolar hyperglycaemic state (HHS): Severe hyperglycaemic emergency with extreme dehydration and high plasma osmolality, typically without significant ketoacidosis.
References
- Point-of-care capillary HbA1c measurement in the emergency department: a useful tool to detect unrecognized and uncontrolled diabetes. International Journal of Emergency Medicine (2016).
- Expanding Diabetes Screening to Identify Undiagnosed Cases Among Emergency Department Patients. Western Journal of Emergency Medicine (2023).
- Evaluating Hospital Revisit Risk in Patients Discharged from the Emergency Department with Blood Glucose of 300 mg/dL (16.7 mmol/L) or Greater. Diabetology (2024).
- The burden of diabetic emergencies on the resuscitation area of a district-level public hospital in Cape Town. African Journal of Emergency Medicine (2021).
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