Longitudinal Trends in the Prevalence of Diabetes Mellitus in an Urban Emergency Department. Issue 4 (April 2016)

• Record Type: Journal Article
• Authors: Sterling, Sarah A.; Jones, Alan E.; Cox, Robert D.
• Is Part Of: Southern medical journal. Volume 109:Issue 4(2016)
• Publication Date: 2016-04
• Subjects: body mass index -- diabetes mellitus -- emergency department -- obesity; Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000000447
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract : Objective: The objective of this study was to examine the longitudinal trends in diabetes mellitus (DM) in emergency department (ED) patients and evaluate the factors associated with those trends. Methods: We conducted a retrospective analysis of all patients who presented to the ED from 2006 to 2011. The presence of DM, height, and weight were recorded prospectively. The study was conducted in the ED of an urban, academic hospital with an average yearly volume of approximately 62, 000 patients. Inclusion criteria were age 16 years and older; presentation to the ED for any reason; and documentation of height, weight, and history of DM. Data were analyzed in 1-year blocks, then examined for trends using linear regression analysis. Data also were examined by obesity class: normal (body mass index [BMI] 20–24.9 kg/m 2 ), overweight (BMI 25–29.9 kg/m 2 ), obese (BMI 30–39.9 kg/m 2 ), and extreme obesity (BMI >40 kg/m 2 ). Results: There was a statistically significant increase in the prevalence of type 2 DM during the study period. The percentage of type 2 DM for all patient visits increased progressively from 10.7% to 16.1% ( r 2 0.97). Progressive increases in yearly type 2 DM prevalence were observed for all BMI classes. The rate of change in the increase of DM was related directly to the degree of obesity. For the normal weight category, the percentage of patients with DM increased 0.5%/year ( r 2 0.92), overweight 0.7%/year ( r 2 0.88), obesity 1.0%/year ( r 2 0.90), and extreme obesity 1.4%/year ( r 2 0.94). Patient age increased slightly for all obesity groups, accounting for a 0.2% to 0.4%/year increase in the prevalence of DM in the population. Conclusions: In this longitudinal analysis, we found an increase in the prevalence of patients with DM and an increase in ED visits by patients with DM. Our results indicate that these increases are influenced most significantly by the obesity level of the patient. Abstract : Diabetes mellitus (DM) is one of the major health problems in the world. The true prevalence of DM is difficult to measure, however, with estimates on the prevalence of DM based largely on telephone interviews, emergency department discharge diagnoses, and national survey data. Although the development of DM is multifactorial and complex, significant risk factors for the development of DM are weight gain and obesity. The goal of this study was to examine the longitudinal trends in DM in emergency department patients and evaluate the factors associated with those trends.