HOW DO INDIVIDUALS WITH DIABETES USE THE ACCIDENT AND EMERGENCY DEPARTMENT

Objective-To determine whether the frequency and pattern of use of the accident and emergency (A&E) department by individuals with diabetes is different from that of the general population. Methods-A historical cohort of 696 individuals with diabetes from six randomly selected ge neral practices and a non-diabetic comparison cohort matched on age, s ex, and general practice were identified. The use of an urban A&E depa rtment by the two cohorts was compared for number of visits between 19 84 and 1996 for injuries, diabetes related and non-diabetes related il lness, proportion referred by a general practitioner, proportion arriv ing by ambulance, and proportion admitted. Results-More visits were ma de by the diabetic cohort (1002 v 706, P = 0.0001); 121 visits were di rectly related to diabetes, including 52 for hypoglycaemia. The diabet ic cohort also had more visits for medical illness unrelated to diabet es (357 v 231, P = 0.0001). The number of visits for injuries was simi lar (524 v 475, P = 0.3). Individuals with diabetes who attended A&E w ere not significantly more Likely to be referred by a general practiti oner (14% v 16%) or admitted (20% v 17%). Conclusions-Individuals with diabetes made more frequent visits than the general population to the A&E department. Since there was no excess of visits for injuries and the proportion requiring admission was similar, the hypothesis that th ey have a different threshold for attending is not supported.