Introduction: Diabetes acute decompensations appear frequently. The most common presentation is CAD and hypoglicemia with roughly 145.000 cases a year. Hyperosmolar state (HOS) presents itself in less than 1% cases. These demand an appropriate and timely recognition and treatment.
Mortality attributable to CAD is 2% in general hospitals and 5% in specialized hospitals. Mortality in HOS is larger, between 15%-70%. This can be attributed to the type of population (advanced age) and to its comorbilities. Mortality due to hypoglicemia is around 20% in insulinized patients vs. 4.5% in non insulinized patients. In Colombia, very little is known about the behaviour of acute decompensations in our patients.
Objective: To describe demographic and clinical characteristics of patients suffering from Diabetes Mellitus 2 who have been admitted with acute decompensations to the internal medicine service in Hospital San José between October 2010 and August 2013.
Methods: Descriptive study which monitored a group of patients admitted to Hospital San José with Diabetes Mellitus type 2 and acute decompensations, recruited between October 2010 and August 2013.
Results: From a total of 470 patients, 45 presented cetoacidosis (9.5%), hyperosmolar state (4%) and hypoglicemia (9.5%). 76% had no decompensation when admitted. Time of evolution of the sickness was 9.7 years for cetoacidosis and for HOS and hypoglicemia approximately 13 years. Only 57% had access to self monitoring.
Women present decompensation more often: 48.9% do in cetoacidosis, 52.6% in hyperosmolar state, 64% in hypoglicemia. The most common reason for admittance is miscelaneous 39.4% followed by infections ( 35%). Most were out of metabolic control hba1c > 9%. 62% cetoacidosis, 68% hyperosmolar state, 33% hypoglicemia. About chronic complications, they were mostly microvascular especially in the hypoglicemic group. Mortality was more present in the CAD 6.6%, followed by hypoglicemia 4.4%. 30% had access to a glucometer for self monitoring. About 15% had suspended treatment for non adherence or non access to health.
Conclusion: The implementation of optimal programs based in a better metabolic control and individual treatment according to each case, the patient’s level of education, self monitoring and a multidisciplinary team can all serve to diminish the presence of acute decompensations. Mortality, when presented, lowers its levels if the cause of precipitation is timely and correctly managed.
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