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Serum biochemistry in Nigerians with hyperglycemic emergencies
Felicia Anumah1, Augustine Ohwovoriole
1Endocrinology Unit, Department of Medicine, Ahmadu Bello University Teaching Hospital Zaria, Kaduna State 810001, Nigeria. anumahma@yahoo.co.uk
Ethnicity & Disease
|May 2, 2008
Summary
Nigerian patients with hyperglycemic emergencies often present with lower plasma glucose levels. A significant portion (25%) exhibit normo-osmolar nonketotic hyperglycemic state (NNHS), an intermediate condition between diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS).
Area of Science:
- Endocrinology and Metabolism
- Internal Medicine
- Biochemistry
Background:
- Plasma biochemical changes are critical for prognostication in hyperglycemic emergencies.
- Detailed biochemical analysis in Nigerian patients with hyperglycemic emergencies is lacking.
- Understanding these biochemical profiles aids in accurate diagnosis and management.
Purpose of the Study:
- To investigate the biochemical profiles of Nigerian patients experiencing hyperglycemic emergencies.
- To compare these profiles with international data and identify unique characteristics.
- To assess the prevalence of diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), and normo-osmolar nonketotic hyperglycemic state (NNHS).
Main Methods:
- Prospective study of patients with hyperglycemic emergency over one year.
- Collection of demographic and clinical data.
- Determination of plasma glucose, electrolytes, urea, and urine analysis (glucose, ketones, protein) pre- and post-treatment.
Main Results:
- Diabetic ketoacidosis (DKA) in 40.6%, hyperglycemic hyperosmolar state (HHS) in 34.4%, and normo-osmolar nonketotic hyperglycemic state (NNHS) in 25% of patients.
- HHS patients had significantly higher mean glucose levels than DKA and NNHS patients.
- DKA patients showed significantly higher mean anion gap and lower plasma bicarbonate compared to NNHS and HHS patients, respectively.
Conclusions:
- Nigerian patients with hyperglycemic emergencies may present with lower plasma glucose levels than reported globally.
- Normo-osmolar nonketotic hyperglycemic state (NNHS) represents a significant subgroup (approx. 25%) with intermediate biochemical features between DKA and HHS.
- Recognition of NNHS is crucial for appropriate management of hyperglycemic emergencies in this population.
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