2004 Volume 47 Issue 12 Pages 931-938
A questionnaire was sent to 310 hospitals in Aichi Prefecture regarding the clinical features and outcome of patients with diabetic ketoacidotic coma (DKA), hyperglycemic hyperosmolar syndrome (HHS), and other types of severe hyperglycemia requiring emergency hospital care during the 6-month period from September 1, 2002 to February 28, 2003. The diagnosis of DKA and HHS was made by each physician according to the guidelines of the Japan Diabetes Society. With the exception of patients with DKA or HHS, other severe hyperglycemic patients without unconsiousness requiring emergency hospital treatment covered by the questionnaire were classified as having severe hyperglycemia without coma (SHW). Replies to the questionnaire were obtained from 101 hospitals.
There were 42 cases of DKA, 30 cases of HHS, and 50 cases of SHW.Two deaths were reported among the 42 DKA cases, and four deaths among the 30 HHS cases. There were three deaths among the 50 SHW cases. There were also 3 cases (1 DKA, 2 HHS) with sequelae assousted with brain damage.Before the hyperglycemic emergency 3 of the 9 patients who died had been treated with SU drugs, one had been treated with insulin and SU drugs, and the other one had received insulin therapy. Two others had received no therapy, and there was no reply concerning therapy in the other 2. The 3 patients with sequelae and the 9 who died included 9 patients over 60 years old.
The above results suggested the importance of early treatment and detection of hyperglycemia, especially among elderly patients treated with SU agents or without insulin therapy.
