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논문 기본 정보

자료유형
학술저널
저자정보
Yun Jae Shin (Department of Internal Medicine National Medical Center) Dae In Kim (Department of Internal Medicine National Medical Center) Dong Won Lee (Department of Internal Medicine National Medical Center) Beung Kwan Jeon (Department of Internal Medicine National Medical Center) Jung Geun Ji (Department of Internal Medicine National Medical Center) Jung Ah Lim (Department of Internal Medicine National Medical Center) Young Jung Cho (Department of Internal Medicine National Medical Center) Hong Woo Nam (Department of Internal Medicine National Medical Center)
저널정보
대한노인병학회 Annals of geriatric medicine and research Annals of geriatric medicine and research Vol.20 No.4
발행연도
2016.1
수록면
185 - 189 (5page)

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Background: Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are two of the most serious acute complications of diabetes mellitus. In this study, we investigated the clinical characteristics of elderly diabetic patients in a hyperglycemic emergency state. Methods: We reviewed the medical records of elderly patients admitted with a diagnosis of DKA and HHS over the past 5 years at the National Medical Center in Korea. Patients were divided into 3 groups: those with only DKA, those with only HHS, and those with both DKA and HHS. We assessed the clinical characteristics, economic vulnerability, precipitating factors, and hospital mortality. Results: Twenty-seven patients (31 episodes) fulfilled the inclusion criteria. Nineteen episodes occurred in male patients. The mean age, blood glucose, and glycosylated hemoglobin (HbA1c) were 78.9 years, 700.7 mg/dL, and 10.6%, respectively. The mean mortality rate was 22.5%; the mortality rates of the DKA only group, the HHS only group, and the group with both DKA and HHS were 10%, 23%, and 37.5%, respectively. DKA was diagnosed in 10 patients (32%), HHS was diagnosed in 13 patients (42%), and both DKA and HHS were diagnosed in 8 patients (26%). There was no relationship between age, sex, economic vulnerability, HbA1c, insulin use, and mortality rate. However, the mortality rate was higher than that of a previous report. Self-discontinuation of diabetes medication and infections are the most common precipitating factors. Conclusion: Elderly patients with diabetes are prone to experience hyperglycemic emergency and have a high mortality rate. Therefore, more focused education and a social medical service system for those with diabetes should be instituted.

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참고문헌 (16)

참고문헌 신청
Kitabchi AE / 2004 / Hyperglycemic crises in diabetes / Diabetes Care 27(Suppl 1):S94~S102 google schola Kitabchi AE / 2009 / Hyperglycemic crises in adult patients with diabetes / Diabetes Care 32:1335~1343 google schola Trachtenbarg DE / 2005 / Diabetic ketoacidosis / Am Fam Physician 71:1705~1714 google schola Wachtel TJ / 1991 / Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island / J Gen Intern Med 6:495~502 google schola Kitabchi AE / 2006 / Hyperglycemic crises in diabetes mellitus: diabetic ketoacidosis and hyperglycemic hyperosmolar state / Endocrinol Metab Clin North Am 35:725~751 google schola

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