11-Year Review of Hyperglycemic Hyperosmolar Syndrome in Diabetics in the Medical Emergency Department of the University Hospital of Bouaké

Abstract

Background: In addition to its pandemic nature, diabetes mellitus presents potentially fatal complications such as hyperglycemic hyperosmolar syndrome. The lack of data on this complication in Côte d’Ivoire over the past 20 years motivated this study. Methods: This is a retrospective descriptive study conducted in the emergency department of the Bouaké University Hospital from 2010 to 2020. It included diabetic patients aged 15 years and over suffering from hyperosmolar hyperglycemic syndrome. Results: The prevalence of hyperglycemic hyperosmolar syndrome was 2.1%. The mean age was 58.8 ± 13.9 years (range 29 - 91 years), and the male-to-female ratio was 1.15. This syndrome was associated with diabetes in 69.6% of cases, of which 87.5% were type 2 diabetes. The main triggering factor was infection (57.1%). Hospitalizations were primarily due to altered mental status (51.8%), dehydration (71.4%), and fever (48.2%). Ketoacidosis was present in 32.1% of cases. The mean blood glucose level was 7.7 g/L (range 6.01 - 18.37), and the mean osmolality was 339.6 mOsm/L (range 320.72 - 389.35). Treatment consisted primarily of rehydration, insulin therapy, and management of precipitating factors. The mean observation period was 2.4 days (range 1 - 5 days). The mortality rate was 51.8%. Conclusion: In Africa, hyperglycemic hyperosmolar syndrome has a high mortality rate, and infections are by far the main triggering factor, highlighting the importance of early diabetes screening and patient education.