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Abdominal pain in patients with hyperglycemic crises
Guillermo Umpierrez1, Amado X Freire
1Department of Medicine and Preventive Medicine, University of Tennessee Health Science Center, Memphis 38163, USA.
Journal of Critical Care
|June 1, 2002
Summary
Abdominal pain is common in diabetic ketoacidosis (DKA), linked to severe acidosis and substance abuse, not hyperglycemia. Investigate pain in DKA only if acidosis is mild or pain persists post-treatment.
Area of Science:
- Endocrinology
- Gastroenterology
- Internal Medicine
Background:
- Abdominal pain is a frequent, yet not fully understood, symptom in diabetic ketoacidosis (DKA).
- The prevalence and clinical significance of gastrointestinal symptoms in hyperglycemic hyperosmolar nonketotic state (HHS) remain underexplored.
Purpose of the Study:
- To evaluate the incidence and prognosis of abdominal pain in patients experiencing DKA and HHS.
- To determine the clinical significance of abdominal pain in hyperglycemic crises.
Main Methods:
- Prospective evaluation of 200 consecutive patients with hyperglycemic crises (189 DKA, 11 HHS).
- Analysis of admission characteristics, laboratory data, and hospital course over 13 months.
Main Results:
- 46% of DKA patients (86/189) experienced abdominal pain, associated with severe metabolic acidosis (lower serum bicarbonate and pH).
- Abdominal pain in DKA was linked to alcohol (51%) and cocaine abuse (13%), but not hyperglycemia or dehydration severity.
- No abdominal pain was reported in HHS patients; one experienced nausea and vomiting.
Conclusions:
- Gastrointestinal symptoms like abdominal pain are common in DKA, correlating with severe acidosis and substance abuse.
- Further investigation for abdominal pain etiology in DKA is recommended only for patients with mild acidosis or persistent pain after ketoacidosis resolution.
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