Hyperglycemic Crisis Characteristics and Outcome of Care in Adult Patients without and with a History of Diabetes in Tigrai, Ethiopia: Comparative Study

Abstract

Getachew Gebremedhin,1 Fikre Enqueselassie1 †, Helen Yifter,2 Negussie Deyessa1 1Department of Community Health and Preventive Medicines, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Endocrinology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia†Professor Fikre Enqueselassie passed away on October 28th, 2019.Correspondence: Getachew Gebremedhin Email [email protected]: To compare hyperglycemic crisis characteristics and outcomes of care in adult patients without and with a history of diabetes in Tigrai, Ethiopia.Methods: A retrospective record review of diabetes patients, 196 without and 393 with a history of diabetes who had been treated in the medical wards from September 1/2017 to August 31/2018, aged 18 years and above was included. An independent-samples t-test/Mann–Whitney tests, χ2-test, and logistic regression analysis were used to analyze the data using SPSS version 25.0.Results: Patients without history of diabetes were younger [43.9± 12.6 vs 48.4± 14.9], more rural residents [53.1% vs 30.3%], lower proportion of type 2 diabetes [38.3% vs 53.7%], hyperosmolar hyperglycemic state [15.8% vs 31.8%], with lower mortality rate [8.7% vs 15.5%] compared to with a history of diabetes. A higher mortality reported in rural residents [13.5% vs 3.3%; without vs 21.8% vs 12.8%; with history], and lower urine ketones [1.9± 1.3 vs 2.8± 1.1; without vs 1.6± 1.2 vs 2.2± 1.0; with a history] compared to their counterparts in both patients, respectively. Rural residents [AOR (95% CI); 3.1 (1.8, 5.4)]; medical history of stroke [AOR (95% CI); 2.7 (1.3, 5.6)]; type 2 diabetes [AOR (95% CI); 2.3 (1.1, 4.7)], hyperglycemic hyperosmolar state [AOR (95% CI); 2.4 (1.1, 5.4)]; and with a history of diabetes [AOR (95% CI); 2.0 (1.04, 3.8)] were significantly associated with mortality, but polydipsia [AOR (95% CI); 0.47 (0.27, 0.81)] was preventive.Conclusion: This finding suggests that rural residents, medical history of stroke, type 2 diabetes, hyperglycemic hyperosmolar state, and with a history of diabetes were independent predictors of mortality while polydipsia was preventive. Therefore, the need for more public health awareness campaigns, screening for people having known risk factors, and expansion of diabetes care services to the primary health care units is a fundamental measure.Keywords: hyperglycemic crisis, mortality, new-onset, with history, outcome

Keywords

• hyperglycemic crisis
• mortality
• new-onset
• with history
• outcome