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Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan
Despite advances in treatments for diabetes mellitus (DM), severe acute glycemic crises still occur. In this study, the characteristics of patients who were transported to an emergency department due to acute glycemic crises were investigated. We enrolled patients who were transported to our hospita...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238261/ https://www.ncbi.nlm.nih.gov/pubmed/34160469 http://dx.doi.org/10.1097/MD.0000000000026505 |
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author | Endo, Keisuke Itoh, Takahito Tanno, Masaya Ohno, Kouhei Hotta, Hiroyuki Kato, Nobuo Matsumoto, Tomoaki Ooiwa, Hitoshi Kubo, Hirofumi Miki, Takayuki |
author_facet | Endo, Keisuke Itoh, Takahito Tanno, Masaya Ohno, Kouhei Hotta, Hiroyuki Kato, Nobuo Matsumoto, Tomoaki Ooiwa, Hitoshi Kubo, Hirofumi Miki, Takayuki |
author_sort | Endo, Keisuke |
collection | PubMed |
description | Despite advances in treatments for diabetes mellitus (DM), severe acute glycemic crises still occur. In this study, the characteristics of patients who were transported to an emergency department due to acute glycemic crises were investigated. We enrolled patients who were transported to our hospital by ambulance due to hypoglycemia or hyperglycemia during the period from January 2015 to December 2019. Initial glucose levels below 70 mg/dL and above 250 mg/dL were defined as hypoglycemia and hyperglycemia, respectively. In the 5-year period, 16,910 patients were transported to our hospital by ambulance. Of those patients, 87 patients (0.51%) were diagnosed with hypoglycemia, 26 patients (0.15%) were diagnosed with hyperglycemia and 1 patient was diagnosed with lactic acidosis. Compared to patients with hypoglycemia, blood urea nitrogen, serum potassium and hemoglobin levels were higher in patients with hyperglycemia. Systolic blood pressure was lower and pulse rate was higher in patients with hyperglycemia, possibly reflecting dehydration in hyperglycemia. Patients with hyperglycemia were younger (63 vs 70 years old, median), more likely to be hospitalized (92.3% vs 23.0%) with poorer prognosis (23.1% vs 4.6%) than those with hypoglycemia. In 64 DM patients with hypoglycemia, 34 patients were treated with insulin and 24 patients were treated with sulfonylurea or glinide, and their medication was often inappropriate. Excessive alcohol intake and malnutrition were the main causes of hypoglycemia in 23 non-DM patients. The main reasons for hyperglycemia were interrupted treatment, forgetting insulin injection and infection. To avoid acute glycemic crises, optimization of anti-DM therapy and education of patients are needed. |
format | Online Article Text |
id | pubmed-8238261 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-82382612021-07-06 Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan Endo, Keisuke Itoh, Takahito Tanno, Masaya Ohno, Kouhei Hotta, Hiroyuki Kato, Nobuo Matsumoto, Tomoaki Ooiwa, Hitoshi Kubo, Hirofumi Miki, Takayuki Medicine (Baltimore) 4300 Despite advances in treatments for diabetes mellitus (DM), severe acute glycemic crises still occur. In this study, the characteristics of patients who were transported to an emergency department due to acute glycemic crises were investigated. We enrolled patients who were transported to our hospital by ambulance due to hypoglycemia or hyperglycemia during the period from January 2015 to December 2019. Initial glucose levels below 70 mg/dL and above 250 mg/dL were defined as hypoglycemia and hyperglycemia, respectively. In the 5-year period, 16,910 patients were transported to our hospital by ambulance. Of those patients, 87 patients (0.51%) were diagnosed with hypoglycemia, 26 patients (0.15%) were diagnosed with hyperglycemia and 1 patient was diagnosed with lactic acidosis. Compared to patients with hypoglycemia, blood urea nitrogen, serum potassium and hemoglobin levels were higher in patients with hyperglycemia. Systolic blood pressure was lower and pulse rate was higher in patients with hyperglycemia, possibly reflecting dehydration in hyperglycemia. Patients with hyperglycemia were younger (63 vs 70 years old, median), more likely to be hospitalized (92.3% vs 23.0%) with poorer prognosis (23.1% vs 4.6%) than those with hypoglycemia. In 64 DM patients with hypoglycemia, 34 patients were treated with insulin and 24 patients were treated with sulfonylurea or glinide, and their medication was often inappropriate. Excessive alcohol intake and malnutrition were the main causes of hypoglycemia in 23 non-DM patients. The main reasons for hyperglycemia were interrupted treatment, forgetting insulin injection and infection. To avoid acute glycemic crises, optimization of anti-DM therapy and education of patients are needed. Lippincott Williams & Wilkins 2021-06-25 /pmc/articles/PMC8238261/ /pubmed/34160469 http://dx.doi.org/10.1097/MD.0000000000026505 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 4300 Endo, Keisuke Itoh, Takahito Tanno, Masaya Ohno, Kouhei Hotta, Hiroyuki Kato, Nobuo Matsumoto, Tomoaki Ooiwa, Hitoshi Kubo, Hirofumi Miki, Takayuki Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan |
title | Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan |
title_full | Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan |
title_fullStr | Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan |
title_full_unstemmed | Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan |
title_short | Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan |
title_sort | characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in japan |
topic | 4300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8238261/ https://www.ncbi.nlm.nih.gov/pubmed/34160469 http://dx.doi.org/10.1097/MD.0000000000026505 |
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