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Not infrequently, type 2 diabetic patients present to emergency departments (EDs) and outpatient practices with severe hyperglycemia. To find out whether the extent of blood glucose lowering during such clinical encounters is related to short-term outcomes, researchers at an urban county hospital conducted a retrospective study of 566 ED visits in which type 2 diabetic patients had initial blood glucose levels ≥400 mg/dL (mean glucose level, 491 mg/dL) and were not admitted to the hospital. Hyperglycemia was the chief complaint for half these visits. No patients had diabetic ketoacidosis or hyperosmolar symptoms. Most patients received subcutaneous insulin, intravenous fluids, or both.
Mean glucose level at time of discharge was 334 mg/dL, w…