Hyperosmolar non-ketotic diabetic coma as a cause of emergency hyperglycaemic admission to Baragwanath hospital

There were 136 emergency hyperglycaemic admissions to Baragwanath Hospital over a 6-month period during 1992-1993, representing 1.2% of the total number of medical admissions; 24 (18%) patients died. Diabetic keto-acidosis (DKA) accounted for 88 (65%) admissions (mortality rate 9%) while 16 admissio...

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Published inSouth African medical journal Vol. 85; no. 3; pp. 173 - 176
Main Authors ROLFE, M, EPHRAIM, G. G, LINCOLN, D. C, HUDDLE, K. R. L
Format Journal Article
LanguageEnglish
Published Pinelands Medical Association of South Africa 01.03.1995
Subjects
Adult
Age Factors
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood Glucose - analysis
Diabetes Complications
Diabetic Ketoacidosis - blood
Diabetic Ketoacidosis - diagnosis
Diabetic Ketoacidosis - mortality
Emergencies
Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition
Female
Hospitalization
Humans
Hyperglycemic Hyperosmolar Nonketotic Coma - blood
Hyperglycemic Hyperosmolar Nonketotic Coma - diagnosis
Hyperglycemic Hyperosmolar Nonketotic Coma - mortality
Intensive care medicine
Male
Medical sciences
Potassium - blood
Sodium - blood
Tropical medicine
Urea - blood
South Africa
Africa
Coma
Human
Hyperglycemia
Emergency
Etiology
Resuscitation
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Summary:There were 136 emergency hyperglycaemic admissions to Baragwanath Hospital over a 6-month period during 1992-1993, representing 1.2% of the total number of medical admissions; 24 (18%) patients died. Diabetic keto-acidosis (DKA) accounted for 88 (65%) admissions (mortality rate 9%) while 16 admissions (12%) were as a result of hyperosmolar non-ketotic coma (HNKC), defined as hyperglycaemia, dehydration and an altered level of consciousness with a plasma osmolality > or = 330 and an arterial pH > or = 7.30, with absent or minimal ketonuria. Of these 16 patients, 9 (56%) were known to have diabetes mellitus. Patients with HNKC were significantly older than those with DKA (P < 0.001) and other patients with nonketotic hyperglycaemia (P < 0.05). The overall mortality rate was 44%; prophylactic low-molecular-weight heparin appeared of benefit (P < 0.05).
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ISSN:0256-9574