Abstract
The article by Keller et al1addressing diabetic ketoacidosis among recently arrested prisoners raises some disturbing issues. The authors found that 70% of the prisoners brought to a single hospital in New York City during a 30-month period with this life-threatening condition had not received their insulin during the period immediately following arrest. The authors are critical of the lack of on-site health personnel and facilities at police lockups and court holding cells and suggest that reliance on emergency departments to provide care for arrestees is inefficient and costly. They recommend instituting a health screening for all arrestees and providing health facilities and personnel on site for those in need of medications. See also p 619. These findings and recommendations parallel those of an American Medical Association (AMA) study—except that study was reported 20 years ago and the focus was on jails.2(Jails are facilities operated by local

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