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Colegio de Medicina Interna de México.

2005, Number 4

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Med Int Mex 2005; 21 (4)

Clinical-epidemiological characteristics of diabetes mellitus' acute complications

Castro SCJ, Cimé AO, Pérez HS, González LMR

Language: Spanish
References: 20
Page: 259-265
PDF size: 69.26 Kb.


ABSTRACT

Background: Diabetes mellitus causes acute and chronic symptoms, most of them can be avoided or modified. Early detection of undiagnosed diabetes mellitus may lead to tighter control or reduction in the severity of complications associated with this disease.
Objective: To determine the prevalence and clinical characteristics of diabetes mellitus in patientes admitted to a public hospital of Merida, Yucatan, requiring emergency care.
Patients and methods: A retrospective, cross-sectional, descriptive, and observational study was conducted in 877 diabetic patients attending the emergency room of Hospital Regional General Benito Juárez García of Merida, Yucatan, from January through December 2003.
Results: Acute complications occurred in 93 patients (34%): 82 patients (29.60%) suffered from hypoglycemia; six (2.1%) had hyperosmolar nonketotic state, and five patients (1.8%) developed diabetic ketoacidosis.
Conclusions: Hypoglycemia was the most common symptom of diabetes mellitus in this group of patients, and it must be taken into account in order to prevent it. Social, cultural, and educational factors could predispose people to diabetes, apart from the complications mentioned above. Hyperosmolar nonketotic state and diabetic ketoacidosis were less frequent. The wide variety of baseline clinical manifestations resembled those found in large series of patients.


REFERENCES

  1. Foster DW. Diabetes mellitus. En: Harrison TR, Fauci AS, Braunwald E, editores. Principios de medicina interna. 14ª ed. México: McGraw-Hill Interamericana, 1999;pp:2341-72.

  2. Velásquez-Monroy O, Rosas-Peralta M, Lara-Esqueda A, et al. Prevalencia e interrelación de enfermedades crónicas no transmisibles y factores de riesgo cardiovascular en México: resultados finales de la Encuesta Nacional de Salud (ENSA) 2000 Arch Inst Cardiol Mex 2003;73(1):62-77.

  3. Secretaría de Salubridad y Asistencia. Servicios de Salud de Yucatán. Principales causas de mortalidad en Mérida, Yucatán, 2000.

  4. Islas S, Revilla MC. Diabetes mellitus: concepto y nueva clasificación. En: Islas S, Lifshitz A, editores. Diabetes. 2ª ed. México: McGraw-Hill Interamericana, 1999;pp:3-13.

  5. Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care 2001;24(1):131-53.

  6. Magee MF, Bhatt BA. Management of decompensated diabetes. Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome. Crit Care Clin 2001;17(1):75-103.

  7. Cryer PE. Hypoglycaemia: the limiting factor in the glycaemic management of type I and type II diabetes. Diabetologia 2002;45:937-48.

  8. Fishbein HA, Palumbo PJ. Acute metabolic complications in diabetes. In: National Diabetes Data Group, editors. Diabetes in America. 2nd ed. Washington, DC: U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995;pp:283-91.

  9. Castro G, Liceaga G. Complicaciones agudas de la diabetes mellitus. En: Islas S, Lifshitz A, editores. Diabetes mellitus. 2ª ed. México: Mcgraw-Hill Interamericana,1999;pp:175-89.

  10. Cryer PE, Davis SN, Shamoon H. Hypoglycemia in diabetes. Diabetes Care 2003;26:1902-12.

  11. The United Kingdom Prospective Diabetes Study Research Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 1998;352(9131):837-53.

  12. The United Kingdom Prospective Diabetes Study Research Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet 1998;352(9131):854-65.

  13. American Diabetes Association. Hyperglycemic crises in patient with diabetes mellitus. Diabetes Care 2001;24:154-61.

  14. McAulay V, Deary IJ, Frier BM. Symptoms of hypoglycaemia in people with diabetes. Diabet Med 2001;18:690-705.

  15. Towler DA, Havlin CE, Craft S, Cryer P. Mechanism of awareness of hypoglycemia: perception of neurogenic (predominantly cholinergic) rather than neuroglycopenic symptoms. Diabetes 1993;42:1791-8.

  16. Sistema Nacional de Información en Salud. URL: http://www.salud.gob.mx/apps/htdocs/estadisticas/publicaciones/publicaciones.htm

  17. U.K. Prospective Diabetes Study Group. U.K. prospective diabetes study 16. Overview of 6 years’ therapy of type II diabetes: a progressive disease. Diabetes 1995;44(11):1249-58.

  18. Gross TM, Mastrototaro JJ, Fredrickson LP. Detection of unseen hypoglycemia using continuous glucose monitoring. Diabetologia 2001;43:A5.

  19. Kitabchi AE, Fisher JN, Murphy MB, Rumbak MJ. Diabetic ketoacidosis and the hyperglycemic hyperosmolar nonketotic state. In: Kahn CR, Weir GC, eds. Joslin’s diabetes mellitus. 13th ed. Philadelphia: Lea & Febiger, 1994;pp:738-70.

  20. Umpierrez GE, Kelly JP, Navarrete JE, et al. Hyperglycemic crises in urban blacks. Arch Intern Med 1997;157(6):669-75.




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