Endocrine Abstracts

Introduction: The management of a diabetic patient in a prison environment is often delicate, which explains the frequency of acute complications in diabetics during the period of incarceration.

Purpose of the study: Describe acute complications in incarcerated diabetic patients and to describe their management within the endocrinology and metabolic diseases department at the CHU IBN ROCHD in Casablanca.

Method: This is a retrospective descriptive study over a period of 2 years from January 1, 2020 to November 30, 2022, including diabetic patients who consulted for acute complications in the endocrinology department during their period of incarceration.

Results: During this study period, 86 detained diabetics consulted for acute complications. Among them, 6 were female (7%), against 80 male patients (93%). The average age of prisoners was 36, with an age range of 18 to 68. Among the population studied, 83.5% had at least one toxic history (tobacco, alcohol, cannabis and psychotropic drugs), most of the patients, i.e. 78.6%, were type 2 diabetics and 21.4% type 1 diabetics with an average duration of diabetes of 15.4 years, 63% of patients were on insulin therapy while 27.4% were on oral antidiabetics and 9.6% on no treatment. The most common reasons for consultation were diabetic ketosis in 54.6% of cases and major hyperglycemia in 42.3% of cases. Among the causes of decompensation, there was a predominance of respiratory infections (41.6%), urinary infections (28.4%) and diabetic foot (15.3%), discontinuation of treatment in particular insulin therapy in type 1 diabetics was involved in 12.4% of cases. Patient care required either hospitalization for a few days (on average 7 days) in 56.3% of cases, or day hospitalization in 31.5% of cases, while 12.2% of patients required only outpatient care. All patients benefited from therapeutic and nutritional education during the hospitalization period, with follow-up consultation thereafter.

Conclusion: Our study showed the high frequency of diabetes-related complications in people in prison. The development of specialized consultations, in particular by telemedicine, as well as therapeutic education are essential to improve the care of incarcerated diabetic patients.