Endocrine Abstracts

Glucose is the primary source of energy for cells and its levels are tightly regulated by the hormone insulin. In people with diabetes, the body either doesn’t produce enough insulin or doesn’t respond to insulin properly. Hyperglycemia can occur which carries high morbidity and mortality. Some common signs and symptoms include polyuria, polydipsia, polyphagia and fatigue. Diabetic ketoacidosis and hyperosmolar hyperglycaemic state are serious medical emergencies associated with uncontrolled levels of blood glucose. The management of acute hyperglycemia in a hospital setting has improved in recent years but still poses a clinical challenge and requires proper evaluation. Measuring blood ketone levels and blood gas remains the important steps when hyperglycaemia is encountered. Short acting insulins are used frequently but require clinical assessment because of the serious risks associated with giving short acting insulin, most importantly hypoglycaemia and symptoms of the patients. Owing to insufficient awareness of guidelines and on-call busy shifts, doctors may prescribe doses of insulin without proper clinical assessment. We gathered data to assess and compare if prescription of short acting insulin was done according to the guidelines to ensure best quality of care to the patients. It is also important to check blood glucose after treatment is given. We audited the management of acute hyperglycemia in clinical settings and found that assessment of clinical features was not done in as many as half of the patients. Also vital investigations like checking for blood ketones was not done in one fifth of the patients and almost half of the patient’s didn’t have their blood glucose checked after giving short acting insulin. This demonstrates a significant gap in clinical understanding and assessment on part of clinicians and through this audit we are trying to highlight the importance of following respective guidelines in the acute management of hyperglycaemia