INCIDENCE, PREDICTORS AND TREATMENT OUTCAME OF HYPERGLYCEMIC EMERGENCY AMONG ADULT DIABETIC PATIENTS IN MIZAN TEPI UNIVERSITY TEACHING HOSPITAL SOUTH WEST, ETHIOPIA, 2022. A RETROSPECTIVE COHORT STUDY

Abstract

Hyperglycemic emergencies (HGEs) are extreme metabolic derangements associated with uncontrolled diabetes mellitus which includes diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). It is the most serious acute complications of diabetes mellitus. Unlike developed countries, developing countries like Sub Saharan countries including Ethiopia mostly focus on communicable disease and HGEs continues to be leading cause of premature mortality among adults with diabetes. Despite the growing up of hyperglycemic emergency impact among adults with diabetes, its incidence and predictors have not been well studied particularly in Ethiopia. So this study aimed to assess the incidence predictors and treatment outcome of hyperglycemic emergency among diabetic patients in mizan tepi university teaching hospital,2022 Method: Institution-based retrospective cohort study design was conducted among adult diabetic patients who were registered from January 1, 2012 to December 31, 2021, in mizan tepi university teaching hospital south west region, Ethiopia. A simple random sampling technique was used to select patients. The data was entered into EPI data version 4.2 and analyzed using SPSS version 24. Cox proportional hazard regression model was fitted to identify the independent predictors of HGEs. Variables having a p-value less than or equal to 0.25 was used a candidate for multivariable Cox proportional hazard analysis. 95% CI of hazard ratio (HR) was computed and variables having a p-value less than 0.05 in the multivariable model was considered as statistically significant with the dependent variable. Multi-collinearities between independent variables was checked by scatter plot and then using correlation matrix for continuous variables and variance inflation factor for categorical variables. Result: A total of 1786 participants were followed for up to 10 years retrospectively. The overall mean follow up month was 39 months. The incidence of hyperglycemic emergency among diabetic patients was 31.6% with 95% CI (29.3-33.8). Sex (AHR = 1.6, P = 0.001), community health insurance (AHR = 1.7, P = 0.001), T1DM (AHR = 2.4, P = ≤ 0.001), presence of complication (AHR = 9.9, P ≤ 0.001), Comorbidity (AHR = 1.67, P ≤ 0.001) were significant predictors. Conclusion: The incidence of HGEs was high as compared to other settings. Sex, Community health insurance, T1DM, complication were the independent predictors. Close monitoring of diabetic patients and considering the effects these factors while running any programs for the diabetic patients.