Given the morbidity and mortality associated with acute hyperglycaemia, and the significant health and financial burden of diabetes, data on prehospital emergency medical service (EMS) use for hyperglycaemia is required to inform interventions and measure improvements. This study aims to investigate utilisation and patterns of demand for prehospital EMS for cases of hyperglycaemia, including characteristics of individuals and factors related to transport to hospital.
A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during the 7 year study period (Jan 2009 – Dec 2015) using data from the Ambulance Victoria data warehouse. Pre-specified variables including data on patient demographics, comorbidities, examination findings, paramedic treatment and transport outcomes were obtained. Logistic regression was used to assess factors associated with transport to hospital.
There were 11,417 cases of hyperglycaemia attended by prehospital EMS during the study period, accounting for 0.3 – 0.4% of the total annual EMS caseload, and equating to 0.54 attendances per 100 people per year. There was a significant increase in annual utilisation, with a 1.7 fold increase in caseload between 2009 (n=1316) and 2015 (n=2325). 50% of individuals had type 2 diabetes, 37% had type 1 diabetes and 8% had no recorded history of diabetes. 90.6% of hyperglycaemia cases were transported to hospital. Factors associated with increased odds of transport in multivariable analysis included no recorded history of diabetes, age
There is substantial utilisation of prehospital EMS for hyperglycaemia, a highly preventable condition. With increased projection of population prevalence of diabetes, further research on opportunities for prevention, as well as optimal management in the prehospital environment is warranted.