000			04107nam a22007697a 4500
008			130224s20132013 xxu||||| |||| 00| 0 eng d
022			_a0145-7217
040			_aOvid MEDLINE(R)
099			_a23610182
245			_aSynergy to reduce emergency department visits for uncontrolled hyperglycemia.
251			_aDiabetes Educator. 39(3):354-64, 2013 May-Jun.
252			_aDiabetes Educ. 39(3):354-64, 2013 May-Jun.
253			_aThe Diabetes educator
266			_d2014-02-24
501			_aAvailable online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006
520			_aCONCLUSION: Diabetes medication management and survival skills education for uncontrolled diabetes may be safely initiated in the ED, as demonstrated by the multidisciplinary STEP-DC intervention, which effectively enabled glycemic control in this pilot study.
520			_aMETHODS: Urban hospital ED patients (n = 86) with BG > 200 mg/dL were enrolled in a 4-week prospective, nonrandomized pilot intervention with historic self-controls. Follow-up visits occurred at 12 to 72 hours, 2 and 4 weeks, and 6 months. T2DM medications were initiated or adjusted at each visit using a guideline-based diabetes medication management algorithm. Survival skills diabetes self-management education and navigation to outpatient services were provided.
520			_aPURPOSE: The purpose of this pilot study was to evaluate the safety and preliminary efficacy of a treatment algorithm and education intervention for the management of patients with type 2 diabetes and hyperglycemia presenting to the emergency department (ED) and stable enough to be discharged home.
520			_aRESULTS: Participants were 51.8% male and 92% black, and 87.3% had private or public insurance. The top reasons for presenting to the ED were no provider appointment available (41.7%) and no primary care provider (14.6%). No hypoglycemia occurred in the first 24 hours following ED T2DM medication initiation or titration and overall hypoglycemia rates were low. BG was reduced from 356 + 110 mg/dL at baseline to 183 + 103 mg/dL at 4 weeks (P < .001).
546			_aEnglish
650			_a*Blood Glucose/de [Drug Effects]
650			_a*Diabetes Mellitus, Type 2/dt [Drug Therapy]
650			_a*Emergency Service, Hospital/ut [Utilization]
650			_a*Hyperglycemia/dt [Drug Therapy]
650			_a*Hypoglycemic Agents/tu [Therapeutic Use]
650			_a*Insulin/tu [Therapeutic Use]
650			_a*Self Care
650			_aAdolescent
650			_aAdult
650			_aAlgorithms
650			_aDiabetes Mellitus, Type 2/ec [Economics]
650			_aDiabetes Mellitus, Type 2/ep [Epidemiology]
650			_aDistrict of Columbia/ep [Epidemiology]
650			_aEmergency Service, Hospital/ec [Economics]
650			_aFeasibility Studies
650			_aFemale
650			_aHumans
650			_aHyperglycemia/ec [Economics]
650			_aHyperglycemia/ep [Epidemiology]
650			_aMale
650			_aMiddle Aged
650			_aPatient Discharge
650			_aPatient Education as Topic
650			_aPilot Projects
650			_aPractice Guidelines as Topic
650			_aProspective Studies
650			_aSelf Care/mt [Methods]
650			_aUrban Population
651			_aMedStar Diabetes Institute
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aEmergency Medicine
656			_aMedicine/Endocrinology
656			_aMedStar Diabetes Institute
657			_aEvaluation Studies
657			_aJournal Article
657			_aResearch Support, Non-U.S. Gov't
700			_aDubin, Jeffrey S
700			_aFokar, Ali
700			_aMagee, Michelle F
700			_aNassar, Carine M
700			_aSharretts, John M
700			_aSmith, Mark S
790			_aCopeland J, Dubin JS, Fokar A, Magee MF, Nassar CM, Sharretts JM, Smith MS
856			_uhttp://dx.doi.org/10.1177/0145721713484593 _zhttp://dx.doi.org/10.1177/0145721713484593
942			_cART _dJournal article
999			_c12146 _d12146