AN OVERVIEW OF ADMISSIONS FOR HYPERGLYCAEMIC CRISES IN HOSPITAL SULTANAH AMINAH JOHOR BAHRU, MALAYSIA

Abstract

INTRODUCTION/BACKGROUND
Hyperglycaemic crises are metabolic emergencies that encompass diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar state (HHS). Both are associated with increased healthcare expenditure, morbidity and mortality.

METHODOLOGY
We describe the clinical and socioeconomic characteristics of patients admitted for hyperglycaemic crises from 1st June 2023 to 31st March 2024 in our hospital. An endocrine team reviewed all admissions for hyperglycaemic crises during the period mentioned above. Patients’ demographic and clinical information were collected as part of routine comprehensive patient evaluation. All data were analysed using GraphPad Prism Version 9.5.0 software.

RESULTS
There were 132 admissions for hyperglycaemic crises (129 DKA and 3 HHS), involving 110 patients (mean age 41.3 years, SD = 17.6; 51.8% female; 57.3% Malay, 20.9% Indian, 19.1% Chinese; 71.3% completed secondary education; 23.6% active smokers). Six patients were readmitted for DKA and one for HHS within 90 days from their index admissions within this period. Fifty-three (55.2%) had a household income of RM 2500 and below. Two-thirds had type 2 diabetes mellitus, while 29.1% had type 1 diabetes. Fifteen patients (13.6%) had DKA as their first presentation of diabetes. Infection was the most common precipitant of hyperglycaemic crises, comprising 60% of cases. Among 95 patients who had pre-existing diabetes, 54.7% had their follow-up at primary care, while 24.2% received care at our endocrine clinic. Forty percent did not conduct selfmonitoring of blood glucose at all. Moreover, at least twothirds of patients with established diabetes fared poorly in sick day rules knowledge assessment.

CONCLUSION
More efforts are needed to reinforce diabetes selfmanagement education and support (DSMES) services at all levels of care to reduce the healthcare burden of hyperglycaemic crises.