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KMID : 0354719810060010019
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Journal of Korean Diabetes Association
1981 Volume.6 No. 1 p.19 ~ p.28
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A Study on Acute Metabolic Complications in Diabetic Patients
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金振民/Kim, Min Jin
尹龍光/朴容準/鄭英/李惠利/洪川洙/許甲範/Yoon, Yong Kwang/Park, Yong Jun/Chung, Young/Lee, Hye Ree/Hong, Chein Soo/Huh, Kap Bum
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Abstract
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Thirty two cases of acute metabolic complications in diabetic patints who were admitted to Yonsei Medical Center, Serverance Hospital from January, 1976 to December, 1980 were studied and the following results were obtained.
1. During the same period, the total in-patients were 105,962 and diabetic patients 2,744(2.6%). Among these diabetic patients, cases of acute metabolic complications were 32(1.16%), DKA 21 cases, HNC 10 cases and lactic acidcsis 1 case. 2. There was no sex difference in prevalance,´and the mean age were 33.3 in DKA and 58.9 years in HNC.
3. The chief complaints on admidssion were mental change(46. 9%), non-specific G-I symptoms (15.6%), general weakness(12. 5%), respiration abnormality(12.5%), seizure and dehydration.
4. The ph7sical findings on admission were severe dehydrat`on(90.6%), changes cf mental status (84.4 %), Knssnaul´s respiration(43.8%), abdominal tenderness, hepatomegaly, and neurolcgic deficit.´
5. The pr.;cipitating factors were infection(28.1 ;o), physical stress(25%), omission cf insulin(18.8 %), G-I and emotional upsets and a´´-cohol cr drug ingestion.
6. The mean p´asna glucose leve´s on admission were 643.8 __156.3 in DKA and 956.6_445.3 mg % in HNC. The mean serum sodium Ieve´s were 124.4-´-39.6 and 153. 4 12. 1. mEq/L, potassium 5.4 _0.9 and 4.6-_1. 14 rnEq/L, CO, c)r.te:.t 7.0=3.8 and 23_._6. 1 mM/L, and ser.t_n cs.r,n.ar_t, 3)7.2=21.9 and 369.4=12. 2 mOsm/kg in DKA and HNC respectively.
7. The total doses of regular insulin required for initial 24 hours after admission were less than 50 units in 17 cases(53.1%), 51 to 100 units in 12 cases (37.5%), and 101 to 150 units in remaining 3 cases (9.4%).
8. The mortality rates of DKA and HNC were 14.3% and 50% respectively. The causes of death were underlying diseases(37. 5%), sepsis(25%) and electrolyte imbalance(25%), but there was no death due to insulin hypoglycemia.
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KEYWORD
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