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Study of the Management of Diabetic Metabolic Emergency in the National Teaching Hospital HKM of Cotonou

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DOI: 10.4236/jdm.2014.44049    3,007 Downloads   3,509 Views   Citations

ABSTRACT

Objective: To study the epidemiological, clinical and therapeutic profile of diabetic metabolic emergencies. Patients and methods: This was a prospective study in descriptive and analytical referred conducted over a period of 6 months in the National Teaching Hosptial HKM of Cotonou December 1, 2011 to May 31, 2012. The patients included in the case of our study were those who, conscious or comatose, had submitted a diabetic hypoglycemia or abnormal blood sugar (2.5 g/l), with a positive glycosuria and ketonuria positive or not. All patients gave their consent for this study. Results: 2786 patients were admitted to the emergency room, 57 (2%) of acute metabolic decompensation of diabetes. DKA accounted for 1.1%, hyperosmolar hyperglycemic syndrome 0.5% and 0.4% hypoglycemia. For hyperglycemic decompensation, sex ratio was 0.8 for females with a mean age of 50.7 ± 16.9 (16-84). For hypoglycemia, male gender was predominant. As decompensation factors for hyperglycemia, infection was found in 54% (n = 30) of cases and stroke by 29% hypertension (n = 15). As for hypoglycemia triggers were dominated by dietary error (50%) and therapeutic errors (25%). 63% (n = 36) of patients underwent resuscitation. More than 3 out of 4 patients were resuscitated to insulin. 98% of patients were rehydrated. The outcome was favorable in 56% of cases. The death rate was 25 % (n = 14). Conclusion: Diabetes mellitus is a serious condition and its severity is mainly due to complications which can be acute or chronic.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Kerekou, A. , Zoumenou, E. , Agbantey, M. , Tiomon, C. , Amoussou-Guenou, D. , Djrolo, F. and Chobli, M. (2014) Study of the Management of Diabetic Metabolic Emergency in the National Teaching Hospital HKM of Cotonou. Journal of Diabetes Mellitus, 4, 359-370. doi: 10.4236/jdm.2014.44049.

References

[1] International Diabetes Federation (IDF) (2011) The Global Burden. 5th Edition, Diabetes Atlas, Brussels. http://www.idf.org/diabetesatlas
[2] Labie, D. (2007) Diabetes in Sub-Saharan Africa. Medical Sciences, 23, 320-322.
[3] Fambo, D. (2008) Prevalence of Hyperglycemia and Hypercholesterolemia in the General Population. University of Abomey Calavi, Cotonou.
[4] Djrolo, F., K. Amoussou-Guenou D., Zannou, D.H., et al. (2003) Prevalence of Diabetes Mellitus in Benin. Louvain Medical Rev. Medical Brussels.
[5] Gninkoun, J.C. (2009) Epidemiological and Clinical Profiles and Therapeutic Ketotic Decompensation of Diabetes Mellitus in the Department of Endocrinology and Metabolic Diseases of CNHU-HKM COTONOU. Thesis in MD, University of Abomey Calavi, Cotonou.
[6] Teke, N. (2003) Profile Epidemiological Clinic Acute Decompensation of Diabetes Mellitus in the General Referral Hospital of Kinshasa. Thesis in MD, University Kimbangu Simon, Kinshasa. http://www.memoireonline.com/12/07/829/m_profil-epidemio-clinique-complications-metaboliques-aigues-diabete-sucre-kinshasa0.html
[7] Sobngwi, E. (2009) National Obesity Centre of Endocrinology and Diabetology, Central Yaoundé DHC Emergency Hospital in Adults. Francophone during Diabetes. World Diabetes Foundation, Cotonou.
[8] Kitabchi, A.E., Umpierrez, G.E., Murphy, B.M. and Kreisberg, R.A. (2006) Hyperglycemic Crises in Adult Patients with Diabetes. Diabetes Care, 29, 2739-2748.
[9] Ramanitriniaina, L.V., Rakotonirina, E.C.J., Rakotndravoavy, L. and Rakotomanga, J.D.M. (2009) Complicated Diabetes: Défis. Médecine Black Africa, No. 5611. 545-548.
[10] Wade, K.A., Niang, E.H.M., Soumare, C.A.T., Diallo, A., Tine, Y. and Diatta, B. (2011) Prise in Charge of Diabetic Ketoacidosis in the Medical Intensive Care Unit of the Main Dakar/SENEGAL Hospital. African Journal of Anesthesiology and Emergency Medicine (RAMUR), 16.
[11] Sidibe, A.T., Cisse, I., Dembele, M., Bocoum, A.I., Aboubacrine, S.A.G., Diarra, S., Traore, A.K. and Traore, H.A. (2005) Diabetes Emergencies: Place Hyperosmolarity. Medicine Black Africa, No. 5210, 552-554.
[12] Ouedraogo, Mr., Ouedraogo, M.S., Ouedraogo, A.S., Zoubga, A.Z., Ouedraogo, G. and Drabo, Y.J. (2001) Place Respiratory Complications in Acute Complications of Diabetes Mellitus National Hospital Yalgado Ouedraogo. Medicine Black Africa, 48, 254-256.
[13] Fattorusso, V. and Ritter, O. (2006) Clinical Vademecum: From Diagnosis to Treatment. 18th Edition, Elsevier/Masson, 1246-1265.

  
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