Endocrine Abstracts

Introduction: Hyperosmolar hyperglycaemic state (HHS) and diabetic ketoacidosis (DKA) are the two most serious acute metabolic complication of diabetes mellitus (DM). The authors propose to characterise the admissions for HHS and DKA at a univeristy hospital.

Methods: An observational, descriptive, and retrospective study in adults admitted to the hospital between January 2009 and October 2013 due to HHS and DKA. The information was accessed via the patients’ electronic records. Statistical analysis was carried out using SPSS.

Results: 71 patients were admitted with HHS, with a dominance of female patients (62%). The median age was 79 years and 38% were considered to have economic difficulties. A quarter of the patients was unaware they were diabetic. The most common clinical manifestation on admission was prostration (65%) and the precipitating factor infections (47%). On admission, 25% were treated with insulin but when they became orientated this percentage went up to 62%. During their admission, 41% of the patients were referred to endocrinology. The median time of stay was 9 days. One year after discharge, 11% of patients had been readmitted for the same reason and 23% had passed away.

In the case of DKA, 44 patients were admitted, 63% being female patients. The median age was 57 years and 51% were considered to have economic difficulties. Half the patients presented with prostration and in 35% of the cases the precipitating factor was lack of compliance with therapy. The median time of stay was 8 days. A quarter of the patients had already had a previous admission and a year after discharge, 30% had been readmitted for the same reason whilst 22% had passed away.

Conclusion: In 5 years, 115 patients were admitted com acute complications of DM. The high incidence of readmissions and mortality in the year following discharge as well as the lack of the compliance with therapy in those admitted with DKA are noteworthy. This shows a need for improved assisted care post-discharge in these patients.