Advances in Obesity Treatment

Demographic Characteristics of Patients with Hyperglycemia in a Single Measurement

Download PDF

Published Date: December 14, 2018

Demographic Characteristics of Patients with Hyperglycemia in a Single Measurement

Sema Avci1*, Gokhan Perincek2

1Amasya University Sabuncuoglu Serefeddin Research and Training Hospital, Amasya, Turkey

2Kars Harakani State Hospital, Kars, Turkey

*Corresponding author: Sema Avci, Department of Emergency Medicine, Amasya University Sabuncuoglu Serefeddin, Research and Training Hospital, Amasya, Turkey, Tel: 90-530-843-1363; E-mail: dnzlsema@gmail.com

Citation: Avci S, Perincek G (2018) Demographic Characteristics of Patients with Hyperglycemia in a Single Measurement. Adv Obs Treat 1(1):101.

 

Abstract

 

Objective: This following study was performed to determine the demographic features of patients with hyperglycemia in a single measurement admitted to emergency room (ER).

Methods: We conducted a retrospective cross-sectional study based on the hospital patients records who admitted to ER. Age, sex, laboratory parameters, blood glucose level, hospitalization results, hospitalization days and one year mortality informations were obtained from the patients’ records.

Results: 46.4% (n = 1351) of patients were male and 53.6% ( n = 1561) were female. The mean age of patients were 62.77 ± 18.030 (min:0–max:101) years. The most common age groups with hyperglycemia were 65–84 (45.47%) and 35–64 (39.7%) years. The mean blood glucose of patients was 352.22 ± 99.0 (min:250–max:1114). 73.2% (n = 2131) of patients were discharged from the ER, 18.4% (n = 91.6) of patients were hospitalized in hospital services and 8.4% (n = 245) of patients were hospitalized in intensive care unit 5.1% (n = 148) of patients died after within one year after the admission to ER. The relationship between hospitalization result and gender is statistically significant. The relationship between one year mortality and gender was not significant.

Conclusion: This study was planned in the emergency department and showed demographic features of patients with one-time hyperglycemia (blood glucose level <250 mg/dL).

Keywords: Hyperglycemia; Blood glucose; Diabetes; Morbidity

 

Introduction

 

Hyperglycemia occurs as a result of stress response in patients with insulin resistance, insulin deficiency, impaired glucose metabolism and using glucocortioids. During acute stress, hyperglycemia is an adaptive response, by furnishing glucose-dependant organ substrate for energy and by protecting intravascular volume with raised serum osmolarity [1].

Diabetes mellitus is a metabolic disease is which there is disorder of energy homeostasis and this disease has adverse effects on health leading to morbidity and mortality. Nowadays, diabetes mellitus is a serious health problem for developed and developing countries [2,3]. In the world, about 150–170 million people suffer from this disease and according to World Health Organization reports: the prevalence of diabetes mellitus is expected to two-fold in 2025 [3]. The acute metabolic complications of DM are associated with volume insuffiency, insulin deficiency and asid-base disorders. The clinical features of diabetic emergencies are hyperglycemia, ketoacidosis, hyperosmolar state and clinical conditions associated with hyperglycemia [2].

Evaluation of patients in all age groups with presenting with hyperglycemia to the emergency department is also important in terms of epidemiological data. Therefore, this following study was performed to determine the demographic features of patients with hyperglycemia in a single measurement admitted to emergency room.

 

Material and Methods

 

Study Design

We conducted a retrospective cross-sectional study based on the hospital patients records admitted to emergency service in Kars Harakani State Hospital, Kars, Turkey. The study protocol was approved by Kafkas University Ethical Commitee and only registry data was used. We included all patients in Kars Harakani State Hospital Emergency Service and measured hyperglycemia (250 mg/dL) once during the dates January 2012 and December 2017. Age, sex, laboratory parameters, blood glucose level, hospitalization results, hospitalization days and one year mortality informations were obtained from the patients’ records.

Statistical analysis

The continuous variables are expressed as mean ± sd, categorical data is expressed as n (%). The normal distribution is determined by histogram and Kolmogorov-Smirnov test. The categorical parameters are compared by Chi Square test. All tests are applied as two tailed and the statistical significance level was p<0.05. All statistical analyses were carried out SPSS 23.0 for Windows program.

 

Results

 

Approximately 1.077.5 patients admitted to ER between the dates. The incidence of patients with a blood glucose level of over 250 was 0.27% in a single measurement.46.4% (n = 1351) of patients were male and 53.6% (n = 1561) were female. The mean age of patients were 62.77 ± 18.030 (min:0–max:101) years. The most common age groups with hyperglycemia were 65-84 (45.47%) and 35–64 (39.7%) years.

The mean blood glucose of patients was 352.22 ± 99.0 (min:250–max:1114). 73.2% (n = 2131) of patients were discharged from the ER, 18.4% (n = 91.6) of patients were hospitalized in hospital services and 8.4% (n = 245) of patients were hospitalized in intensive care unit. Data of a patient could not be reached from recordings. The mean hospitalization day of patients was 1.33 ± 3.62 (min:0–max:29). 5.1% (n=148) of patients died within one year after the admission to ER.

The relationship between hospitalization result and gender is statistically significant (p < 0.005).

 

Discussion

 

Hyperglycemia is a common clinical finding in emergency departments and also one of the main reason for consultation of other pathologies. About 30–40% of admissions to emergency departments are patients with diabetic [4]. In this study, the incidence of hyperglycemia (blood glucose level 250 md/dL<) was 0.27% and 53.6% of patients were female. The mean age of patients were 62.77 ± 18.030 and most common age groups were 65-84 (45.47%) and 35-64 (39.7%) years. The incidence may be low in our study since we do not take hyperglycemia with blood sugar below 250.All age groups were evaluated together. Hyperglycemia was more frequent in elderly patients and for this reason the mean age of the patients was greater. In United States, 11 million people aged 65 years or older (26% of adults aged 65 years or older) suffer from DM. Adults aged 65 years and older are prone to develop DM higher than younger adults [5]. In Lai‘s report, the prevalence of hyperglycemia was high in elderly patients [6]. DM and its complications show gender differences due to countries, lifestyle, culture, environment and socioeconomic status [7]. In Yan et al.’s study, the number of patients presenting with hyperglycemia was higher in males and the mean age of the patients was lower (56.4% male, mean age 48.8) [8]. Age and gender may vary according to the population in which the study conducted.

In this study, 73.2% of patients were discharged from the ER, 18.4% of patients were hospitalized in hospital services and 8.4% of patients were hospitalized in intensive care unit. One year mortality was after the admission to ER was 5.1% for hyperglycemic patients. Hospitalization and gender were associated factors. The discharge from the ER was greater in female gender. Mortality and gender were not related. The discharging from ER was high. It may be because many patients did not present with complications such as hyperosmolar coma or diabetic ketoasidosis. Moderate hyperlycemia is frequently encountered in ER.Patients without complications such as diabetic ketoacidosis may be discharged from the emergency department [9]. Studies have showed a prevalence of hyperglycemia and diabetes ranging 38-40% for hospitalized hyperglycemic patients [10]. Leite et al.’s report, hyperglycemia was correlated with, among other parameters, morbidity/mortality, length of hospitalization and number of re-hospitalizations.

For this study, the biggest limitation is the inability to access patients’ records, especially those containing laboratory results.

 

Conclusion

 

In conclusion, this study was planned in the emergency department showing demographic features of one-time hyperglycemia. There is a need for more comprehensive and prospective  studies including detailed hospital records.

 

Acknowledgements

 

Thanks to Murat Ya?ar Çapan for his contributions for this article.

 

Conflict of interest

 

None to declare.

 

References

 

  1. Patki VK, Chougule SB. Hyperglycemia in critically ill children. Indian J Crit Care Med. 2014;18(1):8-13. doi: 10.4103/0972-5229.125427.
  2. Iloh GUP, Amadi AN. Epidemiology of Diabetic Emergencies in the Adult Emergency Department of a Tertiary Hospital in South-Eastern Nigeria. International Journal of Tropical Disease & Health. 2018;30(1):1-10.
  3. Rana HM, Chavda P, Rathod CC, Mavani M. Socio-Demographic and Anthropometric Profile Of Diabetic Patients Attending Diabetes Clinic ?n Tertiary Care Hospital of Central Gujarat. National Journal of Community Medicine. 2015;6(4):554-557.
  4. Álvarez-Rodríguez E, Agud Fernández M, Caurel Sastre Z, Gallego Mínguez I, Carballo Cardona C, Juan Arribas A, et al. [Recommendations for the management of emergencies in patients with diabetes, acute metabolic complications of diabetes, and steroid-related hyperglycemia]. Emergencias. 2016;28:400-417.
  5. Lee PG, Halter JB. The Pathophysiology of Hyperglycemia in Older Adults: Clinical Considerations. Diabetes Care. 2017;40:444-452.
  6. Lai SW, Tan CK, Ng KC. Epidemiology of Hyperglycemia in Elderly Persons J Gerontol A Biol Sci Med Sci. 2000;55(5):M257-9.
  7. Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278-316. doi: 10.1210/er.2015-1137.
  8. Yan JW, Gushulak GM, Columbus MP, Aarsen K, Hamelin Al, Wells GA, et al. Risk factors for recurrent emergency department visits for hyperglycemia in patients with diabetes mellitus. Int J Emerg Med. 2017;10(1):23. doi: 10.1186/s12245-017-0150-y.
  9. Driver BE, Olives TD, Bischof JE, Salmen MR, Miner JR. Discharge Glucose ?s Not Associated With Short-Term Adverse Outcomes in Emergency Department Patients With Moderate to Severe Hyperglycemia. Ann Emerg Med. 2016;68(6):697-705.e3. doi: 10.1016/j.annemergmed.2016.04.057.
  10. Corsino L, Dhatariya K, Umpierrez G. Management of Diabetes and Hyperglycemia in Hospitalized Patients. Endotext. 2017.
  11. Leite SAO, Locatelli SB, Niece SP, Olivieira ARF, Tockus D, Tosin T. Impact of hyperglycemia on morbidity and mortality, length of hospitalization and rates of re-hospitalization in a general hospital setting in Brazil. Diabetol Metab Syndr. 2010;2:49. doi: 10.1186/1758-5996-2-49. 

 

Copyright: © 2018 Avci S, et al. This an open access article distributed under the Creative Commons Atribution License, which permits unristricted use, distribution, and reproduction in any medium, provided the original work is properly cited.