TITLE:
Study of the Management of Diabetic Metabolic Emergency in the National Teaching Hospital HKM of Cotonou
AUTHORS:
Annelie Kerekou, Eugène Zoumenou, Médard Agbantey, Corneille Tiomon, Daniel Amoussou-Guenou, François Djrolo, Martin Chobli
KEYWORDS:
Ketoacidosis, Diabetes, Decompensation, Ketosis
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.4 No.4,
November
24,
2014
ABSTRACT: Objective: To study the
epidemiological, clinical and therapeutic profile of diabetic metabolic
emergencies. Patients and methods: This was a prospective study in descriptive
and analytical referred conducted over a period of 6 months in the National
Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients
included in the case of our study were those who, conscious or comatose, had
submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a
positive glycosuria and ketonuria positive or not. All patients gave their consent for
this study. Results: 2786 patients were admitted to the emergency room, 57 (2%)
of acute metabolic decompensation of diabetes. DKA accounted for 1.1%,
hyperosmolar hyperglycemic syndrome 0.5% and
0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for
females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender
was predominant. As decompensation factors for hyperglycemia, infection was
found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for
hypoglycemia triggers were dominated by dietary error (50%) and therapeutic
errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out
of 4 patients were resuscitated to insulin. 98% of patients were rehydrated.
The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14).
Conclusion: Diabetes mellitus is a serious condition and its severity is mainly
due to complications which can be acute or chronic.