# Identifying Risk Factors for Poor Glycemic Control among Emergency Department Patients and Improving Linkage to Outpatient Care

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $690,140

## Abstract

PROJECT SUMMARY
Of the millions of Americans who visit an emergency department (ED) each year, there are substantially higher
rates of ED use among racial and ethnic minorities and patients with significant socioeconomic barriers.
However, EDs rarely provide any sort of preventive care, and the care they provide is often not well
coordinated with critically important outpatient care. The consequences are higher rates of undiagnosed
diseases like diabetes among ED patients, which then go untreated, exacerbating health disparities, poor
glycemic control, diabetic complications, and early diabetes-related death. Given the high volume of ED
patients, especially those who are high-risk and have poor access to care, ED-based diabetes screening can
help identify undiagnosed cases and presents an important opportunity to link newly diagnosed patients to
appropriate outpatient care. Nearly 1 in 5 Americans visit an ED in any given year and more than 50% of ED
patients receive some type of blood test. NYU Langone Health has recently launched a system-wide initiative
to screen ED patients already receiving blood work using HbA1c tests. Our preliminary data demonstrate that
this screening approach can help identify ED patients with previously undiagnosed diabetes, especially among
minorities and those without a regular primary care provider. The most critical practical consideration that has
emerged from this initiative is how to improve follow-up with outpatient care. Only 23% of these newly
diagnosed patients had a follow-up outpatient visit within our healthcare system. While these patients may
have had visits elsewhere, this statistic is consistent the low rates of follow-up after ED visits. Therefore, this
proposal seeks to address the following questions: (1) which patients are least likely to follow-up after a new
diagnosis of diabetes, (2) what are the primary reasons why these patients do not follow-up as outpatients, and
(3) whether targeted interventions can help bridge these gaps in care. Therefore, this study will develop clinical
algorithms using data from electronic health records to identify which patients are least likely to follow-up for
patient care after being newly diagnosed with diabetes. It will also perform detailed qualitative interviews
among these newly diagnosed ED patients who fail to follow-up to obtain a comprehensive understanding of
their barriers to care. We will also perform a randomized controlled trial of telemedicine to link ED patients
identified as having newly diagnosed diabetes to appropriate outpatient care. This study will help improve
diabetes surveillance by testing a scalable model to transform EDs into a clinical setting that can effectively
screen and refer the millions of high-risk patients that visit EDs in the United States each year, thereby
reducing disparities in diagnoses, the frequency of diabetic complications, and early diabetes-related death.

## Key facts

- **NIH application ID:** 10913606
- **Project number:** 5R01DK134668-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** David C Lee
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $690,140
- **Award type:** 5
- **Project period:** 2023-08-25 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10913606

## Citation

> US National Institutes of Health, RePORTER application 10913606, Identifying Risk Factors for Poor Glycemic Control among Emergency Department Patients and Improving Linkage to Outpatient Care (5R01DK134668-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10913606. Licensed CC0.

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