Diabetes Electronic Prompt for Improved Care Coordination and Treatment in the ED (DEPICCT)

April 26, 2026 updated by: Paul Peng, MD PhD MSCR, Rutgers, The State University of New Jersey

Diabetes Electronic Prompt for Improved Care Coordination and Treatment (DEPICCT) in the ED

The goal of this clinical trial is to improve the processes of Type 2 Diabetes (T2D) care coordination and treatment in the emergency department (ED) by utilizing clinical decision support mechanisms in the electronic health record (EHR). The main question is whether electronic prompts triggered by hyperglycemia and elevated A1c results in providers providing earlier treatments and faster time to subsequent primary care appointment and greater reduction in hemoglobin A1c (HA1c).

ED clinicians will receive alerts called Our Practice Advisories (OPA's) through the EPIC EHR. The 1st OPA triggers when a random point-of-care (POC) glucose is ≥250 mg/dL, prompting a suggested additional HA1c order. A 2nd OPA triggers if the resulting HA1c is ≥10%, prompting consideration of further care coordination in the Observation Unit. Investigators will compare the outcomes post-intervention compared to pre-intervention.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Type 2 Diabetes (T2D) is a growing public health crisis with rates of diabetes steadily increasing over the last 10 years. The ED is commonly the first point of contact for individuals who present with symptoms of hyperglycemia, often with very severe (HbA1C > 10%) underlying diabetes. However, there is currently no national guideline or clinical policy for the ED management of patients who are not in diabetic ketoacidosis (DKA) or in a hyperglycemia hyperosmolar state (HHS). The investigators hypothesize that there are two subgroups who may benefit from greater care coordination initiated from the ED: patients who are newly-diagnosed with severe T2D and patients whom T2D is poorly-controlled despite medication adherence. This study designs electronic prompt practice advisories that nudge ED providers towards more aggressive treatment pathways. It is currently unknown whether alert tools can improve the delivery and coordination of care of patients with severe T2D presenting to the ED.

Study Type

Interventional

Enrollment (Actual)

300

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New Jersey
      • New Brunswick, New Jersey, United States, 08901
        • Rutgers, Robert Wood Johnson Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Moderate hyperglycemia, (glucose ≥250 mg/dL)

  • Patients who arrive in the emergency department
  • Not pregnant or peri-partum
  • Not SARS-COV-2 PCR positive in past 7 days

Exclusion Criteria:

  • Diabetic ketoacidosis (pH < 7.20, HCO3 < 15, AG > 25)
  • Diabetic foot ulcer or skin complications
  • Hyperglycemic hyperosmolar state with neurologic impairment
  • Patients who leave against medical advice (AMA), elope from the ED, or are transferred to another facility

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention
All ED providers exposed to electronic alerts
Diagnostic test: Hemoglobin A1c
Prompt to order A1c
Behavioral: Observation Unit
Electronic prompt nudging ED provider to consider admitting patient to the Observation Unit for care coordination and more aggressive glycemic control

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Physiologic Response
Time Frame: From date of ED encounter to 4 months after
% Patients achieving: HbA1c 1% reduction in 3 months
From date of ED encounter to 4 months after
Care Coordination: Follow-Up Care
Time Frame: From date of ED encounter until 4 weeks after
% Patients achieving: A T2D-related appointment within 4 weeks
From date of ED encounter until 4 weeks after

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Care Coordination: Length of stay
Time Frame: 1 day
Length of stay (minutes) of subject ED encounter
1 day
Care Coordination: Insurance
Time Frame: Within 3 weeks of ED encounter
Inclusion: patients with NO insurance Measure % Patients achieving new insurance
Within 3 weeks of ED encounter
Care Coordination: Medication Prescription
Time Frame: 3 days

Inclusion: patients discharged from the ED or observation Unit

% subjects prescribed a diabetes medication
3 days
Care Coordination: Medication Change
Time Frame: 3 days

Inclusion: patients discharged from the ED or observation Unit

% subjects with a change in diabetes medication regimen
3 days
Care Coordination: Appointment
Time Frame: 3 months
Time (days) to next appointment related to T2D, calculated as [Appt date] - [ED encounter date]
3 months
Physiologic: A1c Orders
Time Frame: 1 day
Proportion of patients with hemoglobin A1c ordered in the ED
1 day
Physiologic: ED medications
Time Frame: 1 day
% subjects receiving (1) intravenous fluids, (2) insulin, (3) other diabetes medications while in the ED
1 day
Care Coordination: Disposition
Time Frame: Within 1 day of ED encounter date
number of patients discharged, number of patients admitted to observation unit, number of patients admitted to hospital
Within 1 day of ED encounter date
Physiologic: Serum Glucose
Time Frame: 1 day
Serum glucose concentration change from beginning to end of ED encounter
1 day
Physiologic: Hemoglobin A1c percentage
Time Frame: 6 months
Serum hemoglobin A1c (%)
6 months
Physiologic: Diagnosis
Time Frame: 1 day
Proportion of subjects with newly diagnosed Type 2 Diabetes, proportion of subjects with poorly controlled, established Type 2 Diabetes
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Rutgers, The State University of New Jersey

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 30, 2025

Primary Completion (Actual)

April 1, 2026

Study Completion (Actual)

April 26, 2026

Study Registration Dates

First Submitted

March 21, 2025

First Submitted That Met QC Criteria

March 21, 2025

First Posted (Actual)

March 27, 2025

Study Record Updates

Last Update Posted (Actual)

April 30, 2026

Last Update Submitted That Met QC Criteria

April 26, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Pro2024002629

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Subject data stored on RedCap can be extracted with deidentified information for data sharing.

IPD Sharing Time Frame

Until 1 year after study

IPD Sharing Access Criteria

Only the Principal Investigator, PP, will have access

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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