About Duke Urgent Hyperglycemia Clinic

In 2024, Duke Endocrinology opened the first outpatient Urgent Hyperglycemia Clinic (UHC) at the 1A Duke Main Campus clinic. The UHC is a morning clinic Monday through Thursday and is staffed by an endocrine specialty trained advanced practice practitioner (APP). Currently, these APPs are Jessica Paschal, Kelsey Frey, Joseph Giramata, and Tanya Munger. The referral population for this clinic is any patient within the Duke system who has acute hyperglycemia whom their provider feels this clinic would be a good alternative to the emergency department (ED) or urgent care (UC).  

 This is meant to be an alternative for patients with hyperglycemia rather than going to the ED or urgent care. This service is available to all patients with a referral from any provider (for example: transplant, oncology, family medicine, and many more). The patient does not have to be established with endocrinology at Duke to access these services. Ideally, they will be seen in 1-2 business days. Urgent patients have been generally seen the same day that they arrive at their oncology or transplant visit with a significantly elevated glucose.  

Referrals are place in Duke’s electronic health record Epic (Maestro Care) and each referral is closely reviewed by either Dr. Kathryn O’Donnell or Jeremiah Olivas, NP. Tamaura Tutt is the scheduler who does an amazing job of reaching out to these patients to get them in quickly.   

The services available in the UHC are expanded compared to traditional outpatient clinics. For example, the patient can be treated with insulin and/or IV fluids if necessary. The clinic resides on a hospital-based campus so stat labs can be sent and result within a few hours. 

This has been a much-appreciated service by our non-endocrine colleagues and our patients. The clinic allows providers to make high-impact clinical decisions for patients right away at that initial visit. Patients are often able to receive their first continue glucose monitor (CGM) prescription at this visit. The patient will then be matched with an endocrinology provider for ongoing care. 

In its short life span, the clinic has made great impact for both our practice and the Duke providers.