ED & A1c: Testing Up, Control Static
An emergency department (ED) alert system dramatically boosted A1c testing rates among diabetes patients, but did it improve their health? A new study details how an alert implemented in the ED significantly increased the number of patients receiving the primarykeyword A1c test. According too findings in The Journal of emergency Medicine, the initial surge in testing diminished over six years, with long-term glycemic control improvements remaining static. The study, led by Dr. Daniel L. Shaw, reveals that while ED interventions are operationally feasible for A1c increases, the impact on secondarykeyword patient outcomes was less significant. At News Directory 3, we bring you the latest health findings. Discovering the strategies that can sustain the impact of ED-based alerts makes for a better outlook. What’s next in boosting long-term glycemic control?
Emergency Department Diabetes Alert System Boosts A1c Testing, Glycemic Control Lags
Updated May 26, 2025
A new study reveals that implementing an alert system in teh emergency department (ED) significantly increased A1c testing rates for diabetes patients who were overdue for routine monitoring.However, the intervention did not lead to significant improvements in long-term glycemic control, according to research published in The Journal of Emergency Medicine.
The retrospective study, led by Dr. Daniel L. Shaw at Beth Israel Deaconess Medical Center in Boston, analyzed 348,490 ED visits by patients with diabetes between January 2017 and september 2023. In November 2017, an alert was integrated into the ED Information System, targeting 13,609 patients within the health system who had not complied with biannual A1c testing. The intervention focused on patients already undergoing blood tests.
Following the implementation of the alert, physicians ordered A1c tests for 1,442 patients who were previously noncompliant. A1c testing among this group surged from 1.5% to 12.1%. The rate peaked at 22.5% in the first year but gradually decreased to 5.1% after six years. While the alert system proved effective in boosting initial testing rates for A1c levels, the long-term impact on patient health outcomes was less pronounced.
among patients with follow-up data, the average decrease in A1c was -0.42, which researchers resolute was not significantly different from the pre-intervention decrease of -0.60.Furthermore, only 15% of noncompliant patients achieved the target A1c level of less then 7.0, compared to 26% of the general ED population.
The study highlights the operational feasibility of using ED interventions to increase A1c testing for diabetes patients. Though, the authors noted that the effects diminished over time without ongoing educational dialog. “A targeted ED intervention was associated with increased testing for A1c; however, the effects decreased over time without educational communication,” the authors wrote. “While the program demonstrates operational feasibility, it does not appear to result in meaningful improvements in A1c levels relative to the overall ED population.”
What’s next
Future research should explore strategies to sustain the impact of ED-based alerts on A1c testing and investigate complementary interventions to improve long-term glycemic control in patients with diabetes.