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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...

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Autores principales: Endo, Keisuke, Itoh, Takahito, Tanno, Masaya, Ohno, Kouhei, Hotta, Hiroyuki, Kato, Nobuo, Matsumoto, Tomoaki, Ooiwa, Hitoshi, Kubo, Hirofumi, Miki, Takayuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
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.
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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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