Clinical medicine (London, England)
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Medically unexplained symptoms (MUS) are those with no identified organic aetiology. Our emergency department (ED) perceived an increase in MUS frequency during COVID-19. The primary aim was to compare MUS incidence in frequent attenders (FAs) during COVID-19 and a control period. ⋯ During COVID-19, ED attendances reduced by 32.7%, with a significant increase in the incidence of FA-MUS and FA-MUS ED visits compared to control; RR 1.5 (95%CI 1.1-1.8) p=0.0006, and RR 1.8 (95%CI 1.6-2.0), p<0.0001, respectively. Despite reduced ED attendances during COVID-19, there was a significant increase in the incidence of FA-MUS patients and corresponding ED visits by this cohort. This presents a challenge to ED clinicians who may feel underprepared to manage these patients effectively.
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Inpatient hyperglycaemia is associated with poor patient outcomes. The majority of inpatients with diabetes are admitted with non-diabetes-related conditions and are primarily cared for by a clinician who does not specialise in diabetes. We describe common inpatient hyperglycaemia scenarios and outline strategic management approaches for the general physician, enabling better frontline care for people with diabetes.