Hyperglycaemic emergency admissions to a secondary-Level hospital—an unnecessary financial burden

Hyperglycaemic crisis in the Eastern Cape province of South Africa: High mortality and association of hyperosmolar ketoacidosis with a new diagnosis of diabetes

“…100, No. 12 SAMJ NHDKA agrees with other reports, 6,7,11,13 the former had a similar mortality rate to HHS despite the patients being more than 20 years younger. This underscores the need to distinguish between these forms of ketoacidosis, as the combination of hyperosmolality and ketoacidosis had a worse prognosis than ketoacidosis alone despite both ketoacidotic groups being relatively young.…”

“…The overall mortality rate of 20.2% (deaths per all admissions) in the study, with a range from 13.4% for NHDKA to 37.5% for HDKA, is higher than the rates of 2.7 -7.7% for NHDKA and 0 -9.6% for HDKA from centres 6,7,11 that admit patients with hyperglycaemic crisis into high-care units. Patients with hyperglycaemic emergencies in Jamaica, 13 also managed in the medical wards, had lower mortality rates than ours (6.7%, 25% and 20.3% for NHDKA, HDKA and HHS, respectively), indicating that additional factors contribute to our high mortality rates.…”

“…18 Hyperglycaemic hyperosmolar non-ketoacidosis is associated with a higher morbidity and mortality than diabetic ketoacidosis, 6,7,19 which is mainly attributed to hyperosmolality, older age 6,7 and the more frequent association of hyperosmolar non-ketoacidosis with type 2 diabetes. 19 Few studies 6,7,11,13 have described the clinical and laboratory features and outcomes of treatment for hyperosmolar diabetic ketoacidosis. A single report from Africa 11 included only 8 cases.…”

“…19 Few studies 6,7,11,13 have described the clinical and laboratory features and outcomes of treatment for hyperosmolar diabetic ketoacidosis. A single report from Africa 11 included only 8 cases.…”

“…[2][3][4][5][6][7][8][9] It is characteristically classified as ketoacidotic or hyperosmolar. 10 Presentations with the combination of ketoacidosis and hyperosmolality are recognised, 6,7,[11][12][13][14][15][16] and have variably been described as ketoacidosis with hyperosmolality or hyperosmolar state with ketoacidosis, depending on whether ketoacidosis or hyperosmolality was considered dominant. 15 Therapy and outcome of treatment for hyperglycaemic crisis is related to the presence of hyperosmolality and ketoacidosis.…”