Insulin Use in Diabetic Hyperglycemic Emergencies: A Narrative from Benin City, Nigeria
- Corresponding Author:
- Dr Ezeani IU (MBBS, FMCP)
Department of Medicine
Federal Medical Center, P.M.B 7001, Umuahia, Abia state, Nigeria
E-mail: [email protected]
Received Date: June 26, 2015; Accepted Date: July 22, 2015; Published Date: July 27, 2015
Citation: Ugochukwu EI, Ijezie CI, Godswill CO, Arinze OK, Chuku A, et al. (2015) Insulin Use in Diabetic Hyperglycemic Emergencies: A Narrative from Benin City, Nigeria. J Diabetes Metab 6:585. doi:10.4172/2155-6156.1000585
Copyright: © 2015 Ugochukwu EI, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: The primary objective of this study is to determine the types of hyperglycaemic emergencies (HEs) seen in UBTH. The secondary objective is to assess the amount of regular insulin used in various HEs within the first 24 hours to reduce hyperglycaemia (AI24HR), amount of regular insulin used in various HEs to reduce blood glucose level to less than 250 mg/dL (AITRH), and time (in hours) to resolve hyperglycaemia (TRH). Methodology: A total of 105 patients admitted to A&E unit for HEs were included in the study. This was a prospective, longitudinal study in which patients admitted to A&E unit who fulfilled the criteria for HEs were selected using a non-probability sampling technique. Data obtained was analyzed using SPSS version 15. Test statistics used were chi-squared test, student t-test and analysis of variance (ANOVA) while p-value was set at less than or equal to 0.05. Results: Types of HEs found in this study include diabetic ketoacidosis (DKA) seen in 28% of patients, hyperosmolar hyperglycaemic non ketotic state (HHNK) seen in 50%, normo-osmolar non ketotic hyperglycaemic state (NNHS) in 12%, and mixed diabetic ketoacidosis/hyperosmolar hyperglycaemic non ketotic state (DKA/HHNK) seen in 10% of patients. The mean (SD) AITRH in patients that presented with DKA, HHNK, NNHS and Mixed HE were 38.48 ± 15.40, 65.81 ± 15.88, 53.84 ± 15.48, 62.80 ± 12.26 units respectively. Similarly, the mean (SD) AI24HR in patients with DKA, HHNK, NNHS and Mixed HE were 73.17 ± 20.94, 113.4 ± 26.81, 88.31 ± 16.52, 103.0 ± 17.75 units respectively. The TRH in patients that presented with DKA, HHNK, NNHS and Mixed HE were 5.64 ± 4.7, 5.82 ± 3.1, 5.74 ± 2.7, 5.12 ± 2.24 hours respectively. There was statistically significant difference in AI24HR and AITRH in various types of HEs. However, there was no significant difference in TRH. Conclusion: Patients with HHNK constituted the highest number of subjects and they require more regular insulin than patients with other types of HEs.