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Determining Factors of Mortality by Acute Metabolic Complications of Diabetes in the Emergency Department, Hospital of Soavinandriana, Madagascar

Received: 25 July 2022     Accepted: 16 August 2022     Published: 24 August 2022
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Abstract

Introduction: Acute metabolic complications expose diabetic patients to hospital morbidity and mortality. Our study aims to describe the mortality due to these complications in the emergency department in the hospital of Soavinandriana and to determine the factors involved. Methods: This was a cross-sectional analytical study of diabetic patients admitted for acute metabolic complications in the Emergency Department of the Hospital of Soavinandriana, during a period of 24 months. Results: One hundred and five diabetics by three thousand diabetics admitted were selected for the study, giving a prevalence of 3.50%. Diabetes was type 2 in 96.19% of cases, with an average duration of evolution of 8.95 years, fourty percent did not follow any treatment. The duration of diabetes between 10 and 15 years were the most frequently affected. Glycated haemoglobin was ≥ 7% in 70.30% of cases. Ketoacidosis was the most found acute metabolic complication (43.80%), followed by hypoglycemia (28.57%) and hyperosmolar hyperglycemic syndrome (27.62%). With a rate of 26.66%, in-hospital mortality was significantly associated with advanced age, impaired consciousness with glasgow scale less than 12, very high blood glucose, 3+ glucosuria and hypokalemia. Conclusion: Therapeutic education of patients and improvement of accessibility to care are key points to minimize the occurrence of these complications.

Published in International Journal of Diabetes and Endocrinology (Volume 7, Issue 3)
DOI 10.11648/j.ijde.20220703.13
Page(s) 59-62
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Diabetic Ketoacidosis, Hyperglycemic Hyperosmolar Nonketotic Coma, Hypoglycemia, Madagascar, Mortality

References
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[2] Rwiza HT, Swai ABM, McLarty DG. Failure to diagnose diabetic ketoacidosis in Tanzania. Diabet Med 1986; 3: 181–4.
[3] Sidibe EH. Main complications of diabetes mellitus in Africa. Ann. Med. Interne (Paris), vol. 151, 2000, p. 624–8.
[4] Raharinavalona SA, Raherison RE, Razanamparany T, Ralamboson SA, Vololontiana HMD, Rakotomalala ADP. Insulin Availability and Affordability in the Urban Municipality of Antananarivo, Madagascar. International Journal of Diabetes and Endocrinology 2021; 6: 1.
[5] Gosmanov AR, Gosmanova EO, Dillard-Cannon E. Management of adult diabetic ketoacidosis. Diabetes Metab Syndr Obes Targets Ther 2014; 7: 255.
[6] Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L, et al. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 2013; 36: 1384–95.
[7] English P, Williams G. Hyperglycaemic crises and lactic acidosis in diabetes mellitus. Postgrad Med J 2004; 80: 253–61.
[8] Association AD. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2021. Diabetes Care 2021; 44: S15–33.
[9] Holstein A, Plaschke A, Vogel M-Y, Egberts E-H. Prehospital management of diabetic emergencies–a population-based intervention study. Acta Anaesthesiol Scand 2003; 47: 610–5.
[10] Razanamparany T, Raharinavalona SA, Ramalanjaona HR, Raherison RE, Andrianiaina MMA, Randrianomanana TV, et al. Determining Factors of Mortality by Ketoacidosis as Seen in the Unit of Endocrinology at Joseph Raseta Befelatanana Teaching Hospital, Antananarivo-Madagascar. Endocrinology 2022; 7: 43–9.
[11] Organization WH. Global diffusion of eHealth: making universal health coverage achievable: report of the third global survey on eHealth. World Health Organization; 2017.
[12] Skyler JS, Bakris GL, Bonifacio E, Darsow T, Eckel RH, Groop L, et al. Differentiation of diabetes by pathophysiology, natural history, and prognosis. Diabetes 2017; 66: 241–55.
[13] Schectman JM, Nadkarni MM, Voss JD. The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care 2002; 25: 1015–21.
[14] Raharinavalona SA, Raherison RE, Razanamparany T, Ralamboson SA, Rakotomalala ADP, Vololontiana HMD, et al. Factors of Non-adherence to Antidiabetic Drugs in Type 2 Diabetics, Antananarivo Madagascar. International Journal of Diabetes and Endocrinology 2021; 2: 1–92.
[15] Raherison RE, Raharinavalona SA, Ratsimbazafy SJN, Randriamboavonjy RL, Rakotomalala DP, Raveloson NE. Epidemio - clinic profile of diabetics admitted for severe hypoglycemia at the Joseph Raseta Befelatanana Hospital of Antananarivo. Rev Méd Madag 2015; 5: 611–5.
[16] Barski L, Nevzorov R, Rabaev E, Jotkowitz A, Harman-Boehm I, Zektser M, et al. Diabetic ketoacidosis: clinical characteristics, precipitating factors and outcomes of care. Isr Med Assoc J IMAJ 2012; 14: 299–303.
[17] Boucai L, Southern WN, Zonszein J. Hypoglycemia-associated mortality is not drug-associated but linked to comorbidities. Am J Med 2011; 124: 1028–35.
[18] Frank L-A, Solomon A. Hyperglycaemic hyperosmolar state. Br J Hosp Med 2016; 77: C130–3.
Cite This Article
  • APA Style

    Sitraka Angelo Raharinavalona, Thierry Razanamparany, Rija Eric Raherison, Haritsiky Robertini Ramalanjaona, Miora Maeva Arielle Andrianiaina, et al. (2022). Determining Factors of Mortality by Acute Metabolic Complications of Diabetes in the Emergency Department, Hospital of Soavinandriana, Madagascar. International Journal of Diabetes and Endocrinology, 7(3), 59-62. https://doi.org/10.11648/j.ijde.20220703.13

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    ACS Style

    Sitraka Angelo Raharinavalona; Thierry Razanamparany; Rija Eric Raherison; Haritsiky Robertini Ramalanjaona; Miora Maeva Arielle Andrianiaina, et al. Determining Factors of Mortality by Acute Metabolic Complications of Diabetes in the Emergency Department, Hospital of Soavinandriana, Madagascar. Int. J. Diabetes Endocrinol. 2022, 7(3), 59-62. doi: 10.11648/j.ijde.20220703.13

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    AMA Style

    Sitraka Angelo Raharinavalona, Thierry Razanamparany, Rija Eric Raherison, Haritsiky Robertini Ramalanjaona, Miora Maeva Arielle Andrianiaina, et al. Determining Factors of Mortality by Acute Metabolic Complications of Diabetes in the Emergency Department, Hospital of Soavinandriana, Madagascar. Int J Diabetes Endocrinol. 2022;7(3):59-62. doi: 10.11648/j.ijde.20220703.13

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  • @article{10.11648/j.ijde.20220703.13,
      author = {Sitraka Angelo Raharinavalona and Thierry Razanamparany and Rija Eric Raherison and Haritsiky Robertini Ramalanjaona and Miora Maeva Arielle Andrianiaina and Tsikinirina Valisoa Randrianomanana and Andrianirina Dave Patrick Rakotomalala},
      title = {Determining Factors of Mortality by Acute Metabolic Complications of Diabetes in the Emergency Department, Hospital of Soavinandriana, Madagascar},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {7},
      number = {3},
      pages = {59-62},
      doi = {10.11648/j.ijde.20220703.13},
      url = {https://doi.org/10.11648/j.ijde.20220703.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20220703.13},
      abstract = {Introduction: Acute metabolic complications expose diabetic patients to hospital morbidity and mortality. Our study aims to describe the mortality due to these complications in the emergency department in the hospital of Soavinandriana and to determine the factors involved. Methods: This was a cross-sectional analytical study of diabetic patients admitted for acute metabolic complications in the Emergency Department of the Hospital of Soavinandriana, during a period of 24 months. Results: One hundred and five diabetics by three thousand diabetics admitted were selected for the study, giving a prevalence of 3.50%. Diabetes was type 2 in 96.19% of cases, with an average duration of evolution of 8.95 years, fourty percent did not follow any treatment. The duration of diabetes between 10 and 15 years were the most frequently affected. Glycated haemoglobin was ≥ 7% in 70.30% of cases. Ketoacidosis was the most found acute metabolic complication (43.80%), followed by hypoglycemia (28.57%) and hyperosmolar hyperglycemic syndrome (27.62%). With a rate of 26.66%, in-hospital mortality was significantly associated with advanced age, impaired consciousness with glasgow scale less than 12, very high blood glucose, 3+ glucosuria and hypokalemia. Conclusion: Therapeutic education of patients and improvement of accessibility to care are key points to minimize the occurrence of these complications.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Determining Factors of Mortality by Acute Metabolic Complications of Diabetes in the Emergency Department, Hospital of Soavinandriana, Madagascar
    AU  - Sitraka Angelo Raharinavalona
    AU  - Thierry Razanamparany
    AU  - Rija Eric Raherison
    AU  - Haritsiky Robertini Ramalanjaona
    AU  - Miora Maeva Arielle Andrianiaina
    AU  - Tsikinirina Valisoa Randrianomanana
    AU  - Andrianirina Dave Patrick Rakotomalala
    Y1  - 2022/08/24
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijde.20220703.13
    DO  - 10.11648/j.ijde.20220703.13
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 59
    EP  - 62
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20220703.13
    AB  - Introduction: Acute metabolic complications expose diabetic patients to hospital morbidity and mortality. Our study aims to describe the mortality due to these complications in the emergency department in the hospital of Soavinandriana and to determine the factors involved. Methods: This was a cross-sectional analytical study of diabetic patients admitted for acute metabolic complications in the Emergency Department of the Hospital of Soavinandriana, during a period of 24 months. Results: One hundred and five diabetics by three thousand diabetics admitted were selected for the study, giving a prevalence of 3.50%. Diabetes was type 2 in 96.19% of cases, with an average duration of evolution of 8.95 years, fourty percent did not follow any treatment. The duration of diabetes between 10 and 15 years were the most frequently affected. Glycated haemoglobin was ≥ 7% in 70.30% of cases. Ketoacidosis was the most found acute metabolic complication (43.80%), followed by hypoglycemia (28.57%) and hyperosmolar hyperglycemic syndrome (27.62%). With a rate of 26.66%, in-hospital mortality was significantly associated with advanced age, impaired consciousness with glasgow scale less than 12, very high blood glucose, 3+ glucosuria and hypokalemia. Conclusion: Therapeutic education of patients and improvement of accessibility to care are key points to minimize the occurrence of these complications.
    VL  - 7
    IS  - 3
    ER  - 

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Author Information
  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

  • Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar

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