Epidemiology of Diabetic Emergencies in the Adult Emergency Department of a Tertiary Hospital in South-Eastern Nigeria

Abstract

Background: Diabetic emergencies or diabetic crises syndrome are life threatening complications of diabetes mellitus. As the case detection of diabetes mellitus increases in Nigeria, adult diabetic Nigerians are likely to be challenged by diabetic emergencies that predispose them to higher risk of disability and premature death. Aim: The study was aimed at reviewing the epidemiology of diabetic emergencies in the adult emergency department of a tertiary hospital in South-eastern Nigeria. Materials and Methods: This was a retrospective descriptive study that was conducted on patients who presented with diagnoses of diabetic emergencies to the emergency department of Federal Medical Centre, Umuahia, Nigeria. The sources of data were from patients’ case notes; nurses report books, emergency department admission registers and medical records. Information collected were age, sex, time of presentation to the emergency department, month (season) of occurrence, type of diabetic emergency and associated cardiovascular conditions. Results: The age ranged from 25 years to 81 years with mean age of 52.2±8.4 years. There were 86 (55.1%) males and 70 (44.9%) females with male to female ratio of 1.2: 1.  Eighty-eight (56.4%) of the patients presented during the night time, and eighty-two (52.6%) occurred during dry season. The three most common diabetic emergencies were hyperglycaemic hyperosmolar state (50.6%), diabetic ketoacidosis (41.6%) and hypoglycaemic crisis (7.8%). The most commonly associated cardiovascular condition was hypertension. Conclusion: This study has demonstrated the variable epidemiology of diabetic emergencies with hyperglycaemic hyperosmolar state being the commonest hyperglycaemic crises syndrome, hypoglycaemic crisis the least common diabetic emergency and hypertension the commonest co-morbid cardiovascular condition. The incident occurred predominantly among the males, young adults, during dry season and most of the patients presented at night time. The emergency department data should inform the need for proactive primary care and diabetic self-management education.