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Erschienen in: Journal of Diabetes & Metabolic Disorders 2/2018

19.09.2018 | Research Article

Characteristics of hyperglycemic crises in an adult population in a teaching hospital in Colombia

verfasst von: Carlos Esteban Builes-Montaño, Andres Chavarriaga, Lina Ballesteros, Manuela Muñoz, Sofia Medina, Jorge Hernando Donado-Gomez, Alex Ramirez-Rincón

Erschienen in: Journal of Diabetes & Metabolic Disorders | Ausgabe 2/2018

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Abstract

Background

Hyperglycemic crisis are the most serious forms of acute decompensation of diabetes mellitus and require urgent medical attention. The epidemiological data of these conditions in Latin America are scarce and in Colombia unknown, that is why we decided to describe the clinical characteristics and factors associated with the mortality of adults who presented with hyperglycemic crises in a teaching hospital in Colombia.

Materials and methods

Retrospective cohort study of all episodes of hyperglycemic crisis treated in Pablo Tobón Uribe Hospital in a three-year period.

Results

The records of 2233 hospitalization episodes related to diabetes mellitus were review, the prevalence of hyperglycemic crises was 2%, half of the events were diabetic ketoacidosis and 57% of the events occurred in people with type 2 diabetes mellitus, 32% of the events were precipitated by an infection and 27% by and inadequate therapy. The average hospital length of stay was 14 ± 3 days and the mortality rate 2.27%.

Conclusions

In a teaching hospital in Latin America hyperglycemic crises are common, with diabetic ketoacidosis being the most frequent, and in a significant number of cases may be preventable. The hospital length of stay in our population is longer than reported in the literature.
Literatur
2.
Zurück zum Zitat Escobedo J, Buitron LV, Velasco MF, Ramirez JC, Hernandez R, Macchia A, et al. High prevalence of diabetes and impaired fasting glucose in urban Latin America: the CARMELA study. Diabet Med. 2009;26(9):864–71.CrossRefPubMed Escobedo J, Buitron LV, Velasco MF, Ramirez JC, Hernandez R, Macchia A, et al. High prevalence of diabetes and impaired fasting glucose in urban Latin America: the CARMELA study. Diabet Med. 2009;26(9):864–71.CrossRefPubMed
3.
Zurück zum Zitat Aschner P, King H, Triana de Torrado M, Rodriguez BM. Glucose intolerance in Colombia. A population-based survey in an urban community. Diabetes Care. 1993;16(1):90–3.CrossRefPubMed Aschner P, King H, Triana de Torrado M, Rodriguez BM. Glucose intolerance in Colombia. A population-based survey in an urban community. Diabetes Care. 1993;16(1):90–3.CrossRefPubMed
4.
Zurück zum Zitat Aschner P. Diabetes en Latinoamérica. Epidemiología de la diabetes en Colombia. Av Diabetol. 2010;26(02):95–100.CrossRef Aschner P. Diabetes en Latinoamérica. Epidemiología de la diabetes en Colombia. Av Diabetol. 2010;26(02):95–100.CrossRef
5.
Zurück zum Zitat Vargas-Uricoechea H, Casas-Figueroa LÁ. An epidemiologic analysis of diabetes in Colombia. Ann Glob Health. 81(6):742–53. Vargas-Uricoechea H, Casas-Figueroa LÁ. An epidemiologic analysis of diabetes in Colombia. Ann Glob Health. 81(6):742–53.
6.
Zurück zum Zitat Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016;12(4):222–32.CrossRefPubMed Umpierrez G, Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol. 2016;12(4):222–32.CrossRefPubMed
7.
8.
Zurück zum Zitat Anthanont P, Khawcharoenporn T, Tharavanij T. Incidences and outcomes of hyperglycemic crises: a 5-year study in a tertiary care center in Thailand. J Med Assoc Thail. 2012;95(8):995–1002. Anthanont P, Khawcharoenporn T, Tharavanij T. Incidences and outcomes of hyperglycemic crises: a 5-year study in a tertiary care center in Thailand. J Med Assoc Thail. 2012;95(8):995–1002.
9.
Zurück zum Zitat Xu Y, Bai J, Wang G, Zhong S, Su X, Huang Z, et al. Clinical profile of diabetic ketoacidosis in tertiary hospitals in China: a multicentre, clinic-based study. Diabet Med. 2016;33(2):261–8.CrossRefPubMed Xu Y, Bai J, Wang G, Zhong S, Su X, Huang Z, et al. Clinical profile of diabetic ketoacidosis in tertiary hospitals in China: a multicentre, clinic-based study. Diabet Med. 2016;33(2):261–8.CrossRefPubMed
10.
Zurück zum Zitat Alourfi Z, Homsi H. Precipitating factors, outcomes, and recurrence of diabetic ketoacidosis at a university hospital in Damascus. Avicenna J Med. 2015;5(1):11–5.CrossRefPubMedPubMedCentral Alourfi Z, Homsi H. Precipitating factors, outcomes, and recurrence of diabetic ketoacidosis at a university hospital in Damascus. Avicenna J Med. 2015;5(1):11–5.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Abdulrahman GO, Amphlett B, Okosieme OE. Trends in hospital admissions with diabetic ketoacidosis in Wales, 1999-2010. Diabetes Res Clin Pract. 2013;100(1):e7–10.CrossRefPubMed Abdulrahman GO, Amphlett B, Okosieme OE. Trends in hospital admissions with diabetic ketoacidosis in Wales, 1999-2010. Diabetes Res Clin Pract. 2013;100(1):e7–10.CrossRefPubMed
12.
Zurück zum Zitat Olmos P, Donoso A, Arab JP, Niklitschek I, Mertens N, Arce E, et al. Cetoacidosis diabética: Casuística 2008-2012, epidemiología y fisiopatología. Rev Med Chil. 2014;142:1267–74.CrossRefPubMed Olmos P, Donoso A, Arab JP, Niklitschek I, Mertens N, Arce E, et al. Cetoacidosis diabética: Casuística 2008-2012, epidemiología y fisiopatología. Rev Med Chil. 2014;142:1267–74.CrossRefPubMed
13.
Zurück zum Zitat Wachtel TJ, Tetu-Mouradjian LM, Goldman DL, Ellis SE, O'Sullivan PS. Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island. J Gen Intern Med. 1991;6(6):495–502.CrossRefPubMed Wachtel TJ, Tetu-Mouradjian LM, Goldman DL, Ellis SE, O'Sullivan PS. Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island. J Gen Intern Med. 1991;6(6):495–502.CrossRefPubMed
14.
Zurück zum Zitat Domínguez Ruiz M, Calderón Márquez MA, Matías AR. Características clínico epidemiológicas de las complicaciones agudas de la diabetes en el servicio de urgencias del Hospital General de Atizapán. Revista de la Facultad de Medicina (México). 2013;56:25–36. Domínguez Ruiz M, Calderón Márquez MA, Matías AR. Características clínico epidemiológicas de las complicaciones agudas de la diabetes en el servicio de urgencias del Hospital General de Atizapán. Revista de la Facultad de Medicina (México). 2013;56:25–36.
15.
Zurück zum Zitat Ballesteros Calderón AL, Meneses Muñoz ÁP, Ríos Patiño D, Flórez ID, Quevedo VA. Características epidemiológicas y clínicas y hallazgos de laboratorio de los niños menores de 15 años con cetoacidosis diabética atendidos en el Hospital Universitario San Vicente Fundación en Medellín, Colombia, entre enero de 2001 y diciembre de 2010. Iatreia. 2013;26:278–90. Ballesteros Calderón AL, Meneses Muñoz ÁP, Ríos Patiño D, Flórez ID, Quevedo VA. Características epidemiológicas y clínicas y hallazgos de laboratorio de los niños menores de 15 años con cetoacidosis diabética atendidos en el Hospital Universitario San Vicente Fundación en Medellín, Colombia, entre enero de 2001 y diciembre de 2010. Iatreia. 2013;26:278–90.
16.
Zurück zum Zitat Barski L, Nevzorov R, Rabaev E, Jotkowitz A, Harman-Boehm I, Zektser M, et al. Diabetic ketoacidosis: clinical characteristics, precipitating factors and outcomes of care. Isr Med Assoc J. 2012;14(5):299–303.PubMed Barski L, Nevzorov R, Rabaev E, Jotkowitz A, Harman-Boehm I, Zektser M, et al. Diabetic ketoacidosis: clinical characteristics, precipitating factors and outcomes of care. Isr Med Assoc J. 2012;14(5):299–303.PubMed
17.
Zurück zum Zitat Huang CC, Kuo SC, Chien TW, Lin HJ, Guo HR, Chen WL, et al. Predicting the hyperglycemic crisis death (PHD) score: a new decision rule for emergency and critical care. Am J Emerg Med. 2013;31(5):830–4.CrossRefPubMed Huang CC, Kuo SC, Chien TW, Lin HJ, Guo HR, Chen WL, et al. Predicting the hyperglycemic crisis death (PHD) score: a new decision rule for emergency and critical care. Am J Emerg Med. 2013;31(5):830–4.CrossRefPubMed
18.
Zurück zum Zitat Efstathiou SP, Tsiakou AG, Tsioulos DI, Zacharos ID, Mitromaras AG, Mastorantonakis SE, et al. A mortality prediction model in diabetic ketoacidosis. Clin Endocrinol. 2002;57(5):595–601.CrossRef Efstathiou SP, Tsiakou AG, Tsioulos DI, Zacharos ID, Mitromaras AG, Mastorantonakis SE, et al. A mortality prediction model in diabetic ketoacidosis. Clin Endocrinol. 2002;57(5):595–601.CrossRef
19.
Zurück zum Zitat Hughes JS, Averill RF, Eisenhandler J, Goldfield NI, Muldoon J, Neff JM, et al. Clinical risk groups (CRGs): a classification system for risk-adjusted capitation-based payment and health care management. Med Care. 2004;42(1):81–90.CrossRefPubMed Hughes JS, Averill RF, Eisenhandler J, Goldfield NI, Muldoon J, Neff JM, et al. Clinical risk groups (CRGs): a classification system for risk-adjusted capitation-based payment and health care management. Med Care. 2004;42(1):81–90.CrossRefPubMed
20.
Zurück zum Zitat Chung ST, Perue GG, Johnson A, Younger N, Hoo CS, Pascoe RW, et al. Predictors of hyperglycaemic crises and their associated mortality in Jamaica. Diabetes Res Clin Pract. 2006;73(2):184–90.CrossRefPubMed Chung ST, Perue GG, Johnson A, Younger N, Hoo CS, Pascoe RW, et al. Predictors of hyperglycaemic crises and their associated mortality in Jamaica. Diabetes Res Clin Pract. 2006;73(2):184–90.CrossRefPubMed
21.
Zurück zum Zitat Tan H, Zhou Y, Yu Y. Characteristics of diabetic ketoacidosis in Chinese adults and adolescents -- a teaching hospital-based analysis. Diabetes Res Clin Pract. 2012;97(2):306–12.CrossRefPubMed Tan H, Zhou Y, Yu Y. Characteristics of diabetic ketoacidosis in Chinese adults and adolescents -- a teaching hospital-based analysis. Diabetes Res Clin Pract. 2012;97(2):306–12.CrossRefPubMed
22.
Zurück zum Zitat Weinert LS, Scheffel RS, Severo MD, Cioffi AP, Telo GH, Boschi A, et al. Precipitating factors of diabetic ketoacidosis at a public hospital in a middle-income country. Diabetes Res Clin Pract. 2012;96(1):29–34.CrossRefPubMed Weinert LS, Scheffel RS, Severo MD, Cioffi AP, Telo GH, Boschi A, et al. Precipitating factors of diabetic ketoacidosis at a public hospital in a middle-income country. Diabetes Res Clin Pract. 2012;96(1):29–34.CrossRefPubMed
23.
Zurück zum Zitat Dhatariya KK, Nunney I, Higgins K, Sampson MJ, Iceton G. National survey of the management of diabetic ketoacidosis (DKA) in the UK in 2014. Diabet Med. 2016;33(2):252–60.CrossRefPubMed Dhatariya KK, Nunney I, Higgins K, Sampson MJ, Iceton G. National survey of the management of diabetic ketoacidosis (DKA) in the UK in 2014. Diabet Med. 2016;33(2):252–60.CrossRefPubMed
24.
Zurück zum Zitat Alvarez LS, Salmon JW, Swartzman D. The Colombian health insurance system and its effect on access to health care. Int J Health Serv. 2011;41(2):355–70.CrossRefPubMed Alvarez LS, Salmon JW, Swartzman D. The Colombian health insurance system and its effect on access to health care. Int J Health Serv. 2011;41(2):355–70.CrossRefPubMed
26.
Zurück zum Zitat Pinto ME, Villena JE, Villena AE. Diabetic ketoacidosis in Peruvian patients with type 2 diabetes mellitus. Endocr Pract. 2008;14(4):442–6.CrossRefPubMed Pinto ME, Villena JE, Villena AE. Diabetic ketoacidosis in Peruvian patients with type 2 diabetes mellitus. Endocr Pract. 2008;14(4):442–6.CrossRefPubMed
27.
Zurück zum Zitat Farsani SF, Brodovicz K, Soleymanlou N, Marquard J, Wissinger E, Maiese BA. Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review. BMJ Open. 2017;7(7) Farsani SF, Brodovicz K, Soleymanlou N, Marquard J, Wissinger E, Maiese BA. Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review. BMJ Open. 2017;7(7)
28.
Zurück zum Zitat Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX, et al. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. 2004;117(5):291–6.CrossRefPubMed Umpierrez GE, Latif K, Stoever J, Cuervo R, Park L, Freire AX, et al. Efficacy of subcutaneous insulin lispro versus continuous intravenous regular insulin for the treatment of patients with diabetic ketoacidosis. Am J Med. 2004;117(5):291–6.CrossRefPubMed
29.
Zurück zum Zitat Doshi PB, Potter AJ, De Los SD, Darger BF, Patel V, Chathampally Y. Prospective randomized trial of insulin glargine in acute management of diabetic ketoacidosis in the emergency department: a pilot study. Ann Emerg Med. 2013;62(4) Doshi PB, Potter AJ, De Los SD, Darger BF, Patel V, Chathampally Y. Prospective randomized trial of insulin glargine in acute management of diabetic ketoacidosis in the emergency department: a pilot study. Ann Emerg Med. 2013;62(4)
30.
Zurück zum Zitat Freire AX, Umpierrez GE, Afessa B, Latif KA, Bridges L, Kitabchi AE. Predictors of intensive care unit and hospital length of stay in diabetic ketoacidosis. J Crit Care. 2002;17(4):207–11.CrossRefPubMed Freire AX, Umpierrez GE, Afessa B, Latif KA, Bridges L, Kitabchi AE. Predictors of intensive care unit and hospital length of stay in diabetic ketoacidosis. J Crit Care. 2002;17(4):207–11.CrossRefPubMed
31.
Zurück zum Zitat Chen HF, Wang CY, Lee HY, See TT, Chen MH, Jiang JY, et al. Short-term case fatality rate and associated factors among inpatients with diabetic ketoacidosis and hyperglycemic hyperosmolar state: a hospital-based analysis over a 15-year period. Intern Med. 2010;49(8):729–37.CrossRefPubMed Chen HF, Wang CY, Lee HY, See TT, Chen MH, Jiang JY, et al. Short-term case fatality rate and associated factors among inpatients with diabetic ketoacidosis and hyperglycemic hyperosmolar state: a hospital-based analysis over a 15-year period. Intern Med. 2010;49(8):729–37.CrossRefPubMed
Metadaten
Titel
Characteristics of hyperglycemic crises in an adult population in a teaching hospital in Colombia
verfasst von
Carlos Esteban Builes-Montaño
Andres Chavarriaga
Lina Ballesteros
Manuela Muñoz
Sofia Medina
Jorge Hernando Donado-Gomez
Alex Ramirez-Rincón
Publikationsdatum
19.09.2018
Verlag
Springer International Publishing
Erschienen in
Journal of Diabetes & Metabolic Disorders / Ausgabe 2/2018
Elektronische ISSN: 2251-6581
DOI
https://doi.org/10.1007/s40200-018-0353-7

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