In reply: We thank Fourlanos and colleagues for their comments regarding our cluster randomised trial,1 which demonstrated that emergency department screening for diabetes and hyperglycaemia alone did not improve identification of diabetes, documentation of follow‐up plans, or hospital outcomes. The RAPIDS trial has shown that after identification through screening, intervention by a specialised inpatient diabetes team (IDT) is required to achieve improved outcomes.2 But this IDT comes with additional cost, which is a major barrier to the implementation of such teams around Australia.
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- 1. Cheung NW, Campbell LV, Fulcher GR, et al. Routine glucose assessment in the emergency department for detecting unrecognised diabetes: a cluster randomised trial. Med J Aust 2019; 211: 454–459. https://www.mja.com.au/journal/2019/211/10/routine-glucose-assessment-emergency-department-detecting-unrecognised-diabetes
- 2. Kyi M, Colman PG, Wraight PR, et al. Early intervention for diabetes in medical and surgical inpatients decreases hyperglycemia and hospital‐acquired infections: a cluster randomized trial. Diabetes Care 2019; 42: 832–840.
- 3. Davies M, Dixon S, Currie CJ, Davis RE, Peters JR. Evaluation of a hospital diabetes specialist nursing service: a randomized controlled trial. Diabet Med 2001; 18: 301–307.
- 4. Newton CA, Young S. Financial implications of glycemic control: results of an inpatient diabetes management program. Endocrin Pract 2006; 12 (Suppl): 43–48.
- 5. Australian Commission on Safety and Quality in Health Care. Antimicrobial stewardship in Australian health care 2018. Sydney: ACSQHC, 2018. https://www.safetyandquality.gov.au/our-work/antimicrobial-stewardship/antimicrobial-stewardship-australian-health-care-2018 (viewed Feb 2020).
No relevant disclosures.