Diabetic Emergencies: Experience of a Tertiary Endocrine Center

Abstract

Purpose: In this study, we aimed to retrospectively evaluate the demographic data, clinical features, laboratory data, precipitating causes of diabetic emergencies, complications in the follow-up of adult patients who applied to our hospital due to diabetic emergencies. Methods: The study included patients aged 18 years and older referred to a tertiary endocrine center with diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS) hypoglycemia between January 2010 and May 2018. Results: The study was carried out with 165patients, 69(41.8%) males, and 96(58.2%) females. The mean age of the patients was 43.8±20.4(18- 88). Of these patients, 77% (n=127) had DKA, 17% (n=28) had HHS and 6% (n=10) had hypoglycemia. Of the patients 55.2% (n=91) were type 1 DM, 44.8% (n=74) were type 2DM. When the precipitating causes of diabetic emergencies were examined, 32.7%(n=54) poor adherence to treatment and 32.1%(n=53) infection of the patients were involved. The new diagnosis was DM in 10.9% of the patients (n=18). The most common complication after treatment was hypopotassemia with 38.7% (n=60), but no complication was observed in the majority of patients (54.8%). In our study, total mortality was 1.8% and 11.1% in HHS patients. No mortality was found in DKA and hypoglycemia patients. Conclusion: Diabetic ketoacidosis is more common in DM patients than in other diabetic emergencies. Approximately 11% of patients do not have a known diagnosis of diabetes. Poor adherence to treatment and infection are the most important precipitating causes of the diabetic emergency. The mortality rate is very low with early diagnosis and correct treatment.