Hyperglycaemic Emergencies in a Tertiary Health Facility in South-Eastern Nigeria

Patterns of hyperglycaemic emergencies (HE) include diabetic ketoacidosis, (DKA), hyperglycaemic hypero-smolar state, (HHS), normo-osmolar non-ketotic hyper-glycaemic state, (NONKHS), or the mixed/indeterminate form. Certain factors are predictive of adverse HE outcome. There is a paucity of literature on the patterns and poor prognostic factors of HE in the South East (SE) region of Nigeria, hence, the need for this study.

This was a prospective observa-tional study done to assess the pattern of prognostic factors for HE managed at the Federal Medical Centre, (FMC), Umuahia, South East, Nigeria. Consecutively recruited adult patients managed for HE at FMC, Umuahia between July 2015 and March 2016 were studied. Patterns of HE were determined via biochemical tests while prognostic factors were determined from biodata, precipitating illnesses, clinical presentations and other comorbid illnesses. Analysis of data was done using SPSS 20.0 and the level of statistical significance was set at p < 0.05.

A total of 110 subjects were recruited, made up of 46 (42%) males and 64 (58%) females. Death from HE occurred in 10% of the subjects with case fatality rates of 3.6%, 2.7%, and 0.9% for the mixed type, DKA/NONKHS and HHS respectively. Mixed/indeterminate form was the commonest pattern followed by DKA and then NONKHS. The correlates of HE death included stroke, diastolic hypotension and presence of complication(s) attributable to HE but the independent risk factors for death from HE were diastolic hypotension and stroke Cerebrovascular Accident (CVA) only.

Mixed form of HE and DKA were the most common presentations of HE in this facility and the independent risk factors for death from HE were diastolic hypotension and stroke (CVA).