Endocrine Abstracts (2015) 38 P237 | DOI: 10.1530/endoabs.38.P237

Clinical profile and outcome of patients with hyperglycaemic emergencies presenting at a rural hospital in southern Nigeria

Orebowale Olugbemide, Patrick Adunbiola, Idowu Bankole & Kennedy Akhuemokhan

Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.

Background: Hyperglycaemic emergencies (HEs) continues to be important causes of morbidity and mortality among persons with diabetes mellitus. Hyperglycaemic hyperosmolar state (HHS) and diabetic ketoacidosis (DKA) are the two most common acute metabolic complications seen in persons with diabetes mellitus.

Objective: To describe the clinical presentation and outcome of patients with hyperglycaemic emergencies.

Materials and methods: This was a retrospective descriptive study. Records of patients admitted with hyperglycaemic emergency between April 2013 and March 2015 were retrieved. Data was extracted using a standardized questionnaire which included demographic, clinical and laboratory parameters and outcome at discharge.

Results: A total of 88 patients with HE admitted during the period, 61.4% were females. The mean (SD) age for male and female were 60.2 (12.8), 52.2 (18.3) respectively and the P=0.03. Forty seven (53.4%) had HHS, 34 (38.6%) had DKA and 7 (8%) had mixed type of HE. Out of these patients, 28 (31.8%) were newly diagnosed. Sepsis (30.7%) was the commonest precipitant. Other rare precipitants were Stroke (8%) and myocardial infarction (3.4%). The mean (S.D.) values for random blood glucose, osmolality for HHS and DKA were 34.7 (6) mmol/l, 339.0 (19) mmol/kg and 23.9 (7.6) mmol/l, 312 (14.1)mmol/kg respectively. The mean (SD) serum sodium, potassium and urea were 137.5 (6.7) mmol/l, 4.6 (0.95) mmol/l and 12.8 (8.4) mmol/l respectively. Seven (8%) patients developed complications and the commonest was acute kidney injury. Overall case fatality rate was 34.1%. Age, gender, electrolyte derangement and complications did not predict outcome (P>0.05).

Conclusion: Management of HE constitute a great challenge in poor resource countries, hence emphasis should be made on prevention through adequate glycaemic control and prompt implementation of effective treatment guideline.

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