Older Adults with Cancer and Diabetes May Require More Patient Education to Prevent ED Visits

Emergency department (ED) visits are more common among older adults with diabetes. Oncology nurses need to be alert to patients with cancer who also have diabetes, and make sure they have the information they need to prevent unnecessary ED visits.

Diabetes is a risk factor for many types of cancer, and its prevalence is rising. It is estimated that 8-18% of people living with cancer also have type 2 diabetes.

In February 2018, the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) issued a report on the frequency of emergency department (ED) visits made by people with diabetes in 2015. Twelve million ED visits by patients age 45 and older were made, and the visit rate was 2.5 times higher for those age 75 and older than the rate for those age 45—64. Visits for people ages 45-64 requiring hospital admission was 22% compared with 12% of ED visits by patients without diabetes in that age group.

The CDC estimates 30 million Americans have diabetes, and 26 million are age 45 and older. The take-home message is that older people with diabetes are more likely to visit the ED and subsequently be hospitalized than people without diabetes who visit the ED. The researchers concluded that closer monitoring and improved patient education are needed.

The implications for oncology clinicians is that older patients with cancer and diabetes present unique challenges for monitoring. Strategies to reduce ED utilization are needed. These patients also need care coordination of diabetes and cancer treatment. With both cancer and diabetes are prevalent among older people, so there will likely be a need for EDs or areas within existing EDs that focus on the care of the elderly.