Adding Routine A1c Testing to ER Visits Can Save Lives; How a Patient Reversed Diabetes Diagnosis
Reginald Pressoir, a patient administrator at New York University’s Brooklyn Hospital Emergency Department, was going to the bathroom more often than usual. He shared his concern to a nurse manager at work, who then tested his blood sugar levels with a fingerstick. This fast decision would end up changing the course of his life.
A normal glucose level reading is under 100. Pressoir’s was in the 400s.
After further blood testing, Pressoir was quickly diagnosed with type 2 diabetes. While this came to him as a surprise, it did not for his doctors who had observed a rising uptick in type 2 diabetes diagnoses.
According to the Centers for Disease Control and Prevention (CDC), roughly 38% of all U.S. adults had prediabetes based on their fasting glucose or A1C level from 2017-2020. In a new study published by the American Diabetes Association, the number of people under 20 in the U.S. with type 2 diabetes may increase nearly 675% by 2060.
With rising rates of childhood obesity and the growing prevalence of diabetes in people old enough to give birth, this drastic increase shows no signs of stopping.
One of the best chances medical professionals have in fighting against this concerning projection is catching the diabetes as early as they can in as many people as possible. In 2018, NYU had begun offering their emergency room patients A1c blood testing to determine if they had diabetes. Even if testing for diabetes did not appear relevant to the emergencies patients were coming in for, doctors wanted to get to the potential root of their problems and reverse the diabetes crisis.
This program is especially important for patients who have no prior history of diabetes. The CDC reports that 23% of all adults in the U.S., or 8.5 million people have undiagnosed diabetes. People of color were overall more likely to develop diabetes and remain undiagnosed than white people. Adopting routine A1c testing in hospitals can not only save lives, but advance health equity and address widespread disparities in diabetes diagnoses.
he Ronald O. Perelman Department of Emergency Medicine at NYU Langone Health
Source: NYU Langone Health
Dr. Reed Caldwell, who spearheaded this program and serves as the Chief of Service at NYU Langone Perelman Emergency Department, says, “We’ve been seeing 40 to 50 percent [of patients] screened positive for prediabetes or diabetes.”
Although Pressoir was scared, four doctors reassured him that he would be able to overcome it, giving him the resolve he needed to turn his life around. With medication and a complete overhaul of his daily diet and exercise habits, Pressoir lost 30 pounds and after just four months, his blood sugar levels returned to normal.
Now off the medication, Pressoir stays consistent with his healthy diet and fitness, ensuring he continues to be diabetes-free for his long-term future.
To give their patients the care and confidence they need to commit to their health, other hospitals must take note and routinely test people’s A1c levels to screen for underlying conditions before it’s too late.