Recently, the Hyperglycemic crisis is the most severe acute complication of diabetes and is associated with significant morbidity and mortality in diabetes patients. A cross-sectional study is used in the quantitative method. The population in this study are selected under the condition that they must be diabetes type 2 patient, age 18-year-old above, and visit the disease at Sanam Chai Khet Hospital, Sanam Chai Khet District, Chachoengsao Province, Thailand, July 1st,2015 – July 1st,2020
In This study, five years-data collected from 2,834 patients who were diagnosed with Diabetes mellitus at Sanamchaikhet hospital in 5 years 2,761 patients (97.4%) had no hyperglycemic crisis, 59 patients (2.1%) developed HHS, and 14 patients (2.1%) developed DKA. No mixed DKA/HHS has been diagnosed. Diabetic ketoacidosis patients show that they were referred to other hospitals 9(64.3%), admitted to hospital 3(21.4%), and not admitted to hospital 2(14.3%). The patients admitted to the hospital have time to admit about 5.33 days which is precipitated by infection 11(78.6%), the first diagnosis of diabetes mellitus 1(7.1%), Unknown cause 2(7.1%), and diabetic ketoacidosis patient who has complication to need orotracheal tube was 1(7.1%). In a hyperosmolar hyperglycemic state, patients show that they were not admitted to hospital 46(78%), referred to other hospitals 1(1.7%), and admitted to hospital 12(20.3%). The patients admitted to the hospital have time to admit about 7.17 days which is precipitated by infection 5(8.5%), Inadequate insulin 4(6.8%), High sugar intake 3(5.1%), psychological disorder 1(1.7%), and Unknown cause 46(78%). The study shows factors associated with diabetic ketoacidosis in diabetes patients; For Type of Diabetes Mellitus, patients who were unspecified diabetes mellitus are 49.54 times more likely to develop DKA than patients who are type 2 diabetes mellitus (Adjusted OR 49.54, 95%CI = 6.16 – 398.50, p-value <0.001) Smoking, patients who were current smokers are 4.76 times more likely to develop DKA than patients who quit or never smoking (Adjusted OR 4.76, 95%CI = 1.03 – 21.95, p-value 0.04) Alcohol drinking, patients who were current alcohol drinking are 5.85 times more likely to develop DKA than patients who quit (Adjusted OR 5.85, 95%CI = 1.27 – 27.00, p-value 0.02) and Comorbidity, patients who have 1-2 comorbidities drinking are 0.11 times less likely to develop DKA than patients who have no comorbidity (Adjusted OR 0.11, 95%CI = 0.13 – 0.89, p-value 0.04)
The study shows factors associated with the hyperosmolar hyperglycemic state in diabetes patients, Patients with chronic kidney disease are 2.42 times more likely to develop HHS than patients who had no chronic kidney disease (Adjusted OR 2.42, 95%CI = 1.10 – 5.92, p-value 0.027)
