SAT-513 Screening For Uncontrolled Diabetes In The Emergency Department

Abstract Disclosure: A. Zehra: None. B. Buttar: None. Y. Khan: None. T.F. Yip: None. R. Malek: None. E. Fitch: None. K.M. Munir: None. Objective: 50% of individuals with type 2 diabetes (T2D) in the US have hemoglobin a1c >7%. Adherence to regular A1c testing in T2D individuals is low. In inner-city populations, many people lack a primary care provider (PCP) and seek healthcare in the emergency department (ED). Targeted real-world screening approaches may help identify individuals with uncontrolled diabetes. We hypothesized that longer intervals from prior A1c testing would be associated with higher levels of uncontrolled T2D. Individuals were assessed for time since the last A1c test and other factors (age, PCP usage, etc.). Methods: All individuals presenting to the ED who were ≥ 18 years old, had a history of T2D, and had not had an A1c test in 3 months were approached for point-of-care A1c testing. Individuals with prediabetes, an unknown history of diabetes, or for whom A1c data was missing were excluded. Results: Out of 368 patients with prior T2D, 26 had an A1c within 90 days, 53 declined testing, and 58 had unavailable A1c data due to “other” reasons. Out of the 231 individuals analyzed, 168 (72.7%) had an A1c ≥ 7%. Increased time since last A1c (every 3 months) was associated with achievement of glycemic control in univariate analysis (OR 1.04 CI 1.00-1.07, p = 0.044). However, the multivariate analysis showed no association. On multivariate analysis, increased age was associated with a higher likelihood of a ≥ 12-month interval since the last A1c (OR 1.03, CI 1.01-1.05, p=0.015), whereas PCP usage showed a lower likelihood of the last A1c being ≥ 12 months ago (OR 0.28 CI 0.09-0.92, p = 0.35). Conclusion: Targeted real-world A1c screening in an inner-city ED showed a higher-than-average prevalence of uncontrolled diabetes. Contrary to our hypothesis, longer duration since prior A1c did not correlate with higher A1c levels. Presentation: Saturday, July 12, 2025