Type 2 Diabetes Mellitus and Hyperglycemia in Medical-IcuMorbidiy, Mortality and Functional Outcome

Abstract

Introduction:Diabetes mellitus, a major lifestyle disease is undoubtedly the most challenging public health problem of 21st century with a worldwide prevalence of 387 million (8.3%) and predicted to be 592 million by 2035. 77% of people with diabetes live in low- and middle-income countries. India, once known as the ‘diabetes capital of the world’ was home to 61.3 million patients with T2DM in 2011 with predictions of 101.2 million diabetics by 2030. India is second only to China which is home to 92.3 million diabetics. The International Diabetes Federation estimated a doubling of diabetic population between 1995 and 2005, and predicted 70 million diabetics by 2025. Materials and Methods:Patients admitted to the Medical ICU during a consecutive period of four months from November 2014 to February 2015.Study was conducted among the patients admitted to the Medical ICU through the OP Department and casualty. Detailed history and physical examination along with relevant investigations were done after getting written, informed consent A proper proforma was set up emphasizing history, physical findings, and investigations.Results:Out of the total 144 patients 27 (18.75%) were found hyperglycemic with a history of Diabetes Mellitus and 20 (13.88%) were hyperglycemic without a history of DM. Rest ofthemi.e 97patients(67.36%)were found to be normoglycemic.Conclusion: Patients admitted with Infections and Poisoning have a higher chance to remain normoglycemic. Patients with Cardiovascular diseases are prone to become hyperglycemic. Snake bite and other poisonings have lesser chance to develop hyperglycemia. Hyperglycemia in general leads a poor functional outcome. Treatment with Insulin does not cause any significant variation in the mortality rate of the glycemic group when compared to the normoglycemics. Hyperglycemia can lead to increased mortality. Known diabetics and new hyperglycemics have equal mortality rate.