Abstract:
Hyperglycemic emergencies (HGEs) are extreme metabolic derangements
associated with uncontrolled diabetes mellitus which includes diabetic ketoacidosis (DKA) and
hyperglycemic hyperosmolar syndrome (HHS). It is the most serious acute complications of
diabetes mellitus. Unlike developed countries, developing countries like Sub Saharan countries
including Ethiopia mostly focus on communicable disease and HGEs continues to be leading cause
of premature mortality among adults with diabetes. Despite the growing up of hyperglycemic
emergency impact among adults with diabetes, its incidence and predictors have not been well
studied particularly in Ethiopia. So this study aimed to assess the incidence predictors and treatment
outcome of hyperglycemic emergency among diabetic patients in mizan tepi university teaching
hospital,2022
Method: Institution-based retrospective cohort study design was conducted among adult diabetic
patients who were registered from January 1, 2012 to December 31, 2021, in mizan tepi university
teaching hospital south west region, Ethiopia. A simple random sampling technique was used to
select patients. The data was entered into EPI data version 4.2 and analyzed using SPSS version
24. Cox proportional hazard regression model was fitted to identify the independent predictors of
HGEs. Variables having a p-value less than or equal to 0.25 was used a candidate for multivariable
Cox proportional hazard analysis. 95% CI of hazard ratio (HR) was computed and variables having
a p-value less than 0.05 in the multivariable model was considered as statistically significant with
the dependent variable. Multi-collinearities between independent variables was checked by scatter
plot and then using correlation matrix for continuous variables and variance inflation factor for
categorical variables.
Result: A total of 1786 participants were followed for up to 10 years retrospectively. The overall
mean follow up month was 39 months. The incidence of hyperglycemic emergency among diabetic
patients was 31.6% with 95% CI (29.3-33.8). Sex (AHR = 1.6, P = 0.001), community health
insurance (AHR = 1.7, P = 0.001), T1DM (AHR = 2.4, P = ≤ 0.001), presence of complication
(AHR = 9.9, P ≤ 0.001), Comorbidity (AHR = 1.67, P ≤ 0.001) were significant predictors.
Conclusion: The incidence of HGEs was high as compared to other settings. Sex, Community
health insurance, T1DM, complication were the independent predictors. Close monitoring of
diabetic patients and considering the effects these factors while running any programs for the
diabetic patients.
