Table 1.
Comparison of the clinical characteristics of patients with a hyperglycemic crisis without and with a history of diabetes
| Variable | History of diabetes | All (n = 330) | P-value | |
|---|---|---|---|---|
| Without (n = 81) | With (n = 249) | |||
| Age (years) | 54.3 ± 20.2 | 62.5 ± 21.3 | 60.5 ± 21.3 | 0.003 |
| Elderly, aged ≥65 years (%) | 30.9 | 55.4 | 49.4 | < 0.001 |
| Sex, male (%) | 63.0 | 44.6 | 40.1 | 0.004 |
| Vital signs | ||||
| Glasgow coma scale | 13.6 ± 3.0 | 12.5 ± 3.5 | 12.8 ± 3.4 | 0.007 |
| Altered mental status (%) | 25.9 | 39.8 | 36.4 | 0.025 |
| SBP | 140.0 ± 25.1 | 134.9 ± 34.4 | 136.3 ± 32.4 | 0.13 |
| Heart rate | 111.0 ± 22.0 | 111.5 ± 23.8 | 111.4 ± 23.3 | 0.846 |
| Body temperature | 36.8 ± 1.1 | 36.8 ± 1.2 | 36.8 ± 1.1 | 0.694 |
| Respiratory rate | 20.4 ± 3.9 | 20.9 ± 5.3 | 20.8 ± 5.0 | 0.398 |
| Symptoms/signs (%) | ||||
| Thirst | 43.2 | 10.4 | 18.5 | < 0.001 |
| Polydipsia | 34.6 | 6.0 | 13.0 | < 0.001 |
| Polyuria | 39.5 | 8.4 | 16.1 | < 0.001 |
| Bodyweight loss | 32.1 | 5.1 | 11.5 | < 0.001 |
| Medical history (%) | ||||
| Hypertension | 38.3 | 45.6 | 45.4 | 0.191 |
| Stroke | 11.1 | 20.9 | 18.5 | 0.05 |
| Chronic renal insufficiency | 0 | 16.9 | 12.7 | < 0.001 |
| Cancer | 8.6 | 8.4 | 8.5 | 1.000 |
| Nasogastric tube feeding | 3.7 | 10.8 | 9.1 | 0.073 |
| Bedridden | 7.4 | 15.3 | 13.3 | 0.09 |
| Nursing home resident | 0 | 3.6 | 2.7 | 0.12 |
| Laboratory data | ||||
| Blood glucose (mg/dL) | 852.3 ± 378.0 | 700.7 ± 293.7 | 737.9 ± 322.5 | 0.001 |
| WBC (cells/mm3) | 13400.0 ± 5788.2 | 12700.0 ± 5903.2 | 12900.0 ± 5874.8 | 0.335 |
| Hemoglobin (g/dL) | 15.6 ± 2.6 | 13.3 ± 2.9 | 13.9 ± 3.0 | < 0.001 |
| Platelet (1,000/mm3) | 240.3 ± 74.7 | 235.5 ± 95.7 | 236.7 ± 90.9 | 0.638 |
| Osmolality (mOsm/kg)* | 323.8 ± 32.2 | 325.9 ± 30.2 | 325.4 ± 30.7 | 0.581 |
| Blood urea nitrogen (mg/dL) | 34.1 ± 23.7 | 48.7 ± 33.2 | 45.1 ± 31.7 | < 0.001 |
| Serum creatinine (mg/dL) | 1.8 ± 0.8 | 2.2 ± 1.6 | 2.1 ± 1.5 | 0.001 |
| Blood PH† | 7.3 ± 0.1 | 7.3 ± 0.1 | 7.3 ± 0.1 | 0.333 |
| HbA1c (%) | 11.9 ± 2.9 | 11.7 ± 3.1 | 11.7 ± 3.0 | 0.571 |
| Precipitating factor (%)‡ | ||||
| Poor compliance | NA | 80.9 | 60.3 | NA |
| Infection | 28.4 | 50.6 | 45.2 | < 0.001 |
| Pancreatitis | 2.4 | 3.3 | 3.0 | > 0.95 |
| Acute coronary syndrome | 0 | 3.7 | 2.7 | 0.119 |
| Stroke | 1.2 | 1.6 | 1.5 | > 0.95 |
| Subgroup diagnosis (%) | ||||
| DKA | 37.0 | 29.7 | 31.5 | 0.218 |
| HHS | 46.9 | 59.4 | 56.4 | 0.048 |
| Mixed DKA/HHS | 16.0 | 10.8 | 12.1 | 0.212 |
| 30-day mortality rate (%) | 3.7 | 12.9 | 10.6 | 0.021 |
Data are means ± standard deviation unless otherwise indicated.
*
Effective serum osmolality: 2 (measured Na+ [mEq/L]) + (glucose [mg/dL]) / 18.
†
91.8% (303/330) of the patients had this test.
‡
Patients might have multiple precipitating factors. DKA, diabetic ketoacidosis; HbA1c, glycated hemoglobin; HHS, hyperosmolar hyperglycemic state; NA, not applicable; SBP, systolic blood pressure; WBC, white blood cell count.