Hyperglycaemic Emergencies – A Need For An Appropriate Diagnosis.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 3
Abstract
Background: Hyperglycaemic Emergencies, He, Is An Acute Metabolic Complication Of Diabetes Mellitus (Dm) Characterized By Hyperglycaemia, Dehydration, Changes In Plasma Osmolality And Electrolytes Disorders In Which Soluble Insulin And Intravenous Fluids Are Required For Correction. Treatment Outcome Is Determined Largely By Its Precipitating Factors And Co-Morbid Conditions, Accurate Diagnosis And Proper Management.Objectives: To Highlight The Need For Accurate Diagnosis Of Diabetic Keto-Acidosis, Dka, Hyperosmolar Hyperglycaemic State, Hhs Etc, Draw Attention To Errors In Management Of Hyperglycaemic emergencies And Create Awareness For Early Endocrinology Review Case Reports:Case 1Mrs F.N Is 46 Years Old, Living With Diabetes, Admitted Via The Accident And Emergency (A & E) Department On Account Of Cerebro-Vascular Accident, Cva (Stroke) With Random Blood Glucose, Rbg Of 563mg/Dl. History Of Severe Headache, Vomiting, Fits, Fever And Neck Stiffness Were Absent. An Urgent brain Ct Scan Excluded A Haemorrhagic Stroke. He Presented At A & E To A Medical Unit Who Admitted And Managed For Cva (Stroke). Endocrinology Review Was Sought One Week Post Admission When His Condition Has Deteriorated.Case 2Mr Z.O Is A 63 Year Old FarmerAdmitted At The A & E Unit With A Diagnosis Of Poor Glycaemic Control And Right Diabetic Foot Ulcer With Bacterial Infections. Rbg At Presentation Was 1015mg/Dl. He Was Placed On Antibiotics And Subcutaneous T.D.S Soluble Insulin. Endocrinology Review Was Asked For After The Patient Has Been In The Medical Ward For 9 Days And In A Poorer Clinical State Than When He Presented At A & E.ConclusionHyperglycaemic Emergencies Were Not Diagnosed Appropriately In These Cases Admitted By Other Medical Specialties, Precipitants And Co-Morbid Conditions Were Not Identified For What They Were While Hyperglycaemic emergencies Were Not Managed Based On The Local Treatment Guidelines With Early Involvement Of The Diabetes Care Team.
Authors and Affiliations
Nkpozi Mo1, Ezeani Iu1, Ugochukwu Oc, Unachukwu Cn, Chapp Jumbo Au3
Keywords
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- EP ID EP366035
- DOI 10.9790/0853-1703036871
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