Preoperative "NPO" as an opportunity for diabetes screening.

摘要: BACKGROUND: Novel preventive care opportunities, such as in hospitalized patients, may merit further investigation an Accountable Care Organization (ACO) model. As 40% of patients with diabetes are undiagnosed, screening is urgent public health need. Screening fasting preoperative present effective means to identify who might otherwise remain undiagnosed. OBJECTIVE: To pilot inpatient strategy for that would ascertain prevalence unrecognized (DM) and impaired glucose (IFG), determine reproducibility blood (FBG), establish feasibility screening. DESIGN: Prospective observational study. SETTING: Large Midwestern academic medical center. PATIENTS: Two hundred seventy-five elective orthopedic a visit between December 1, 2007 November 30, 2008. Most (96.6%) had seen their primary provider (PCP) within 12 months, 100% were insured. MEASUREMENTS: Medical history was recorded, hemoglobin A1C (Hgb A1C) FBG drawn immediately prior surgery. Patients ≥100 mg/dL 6–8 weeks postoperatively. RESULTS: Twenty-four percent (67/275) previously DM or IFG by virtue 2 abnormal values. Sixty-four preoperatively remained elevated at ambulatory follow-up. No new point-of-care checks ordered dysglycemia mentioned on discharge summary. CONCLUSIONS: Inpatient undiagnosed common, even insured, surgery recent visits. Preoperative can be used screen, but results need conveyed PCPs. Journal Hospital Medicine 2012; © 2012 Society