Assessment of Metabolic Derangements in Diabetes and Associated Hyperglycemic Emergencies

Abstract

Objective: To assess and compare the plasma insulin level and Pre-treatment metabolic and acid base status findings in patients with uncontrolled T1DM, uncontrolled T2DM, DKA and HHS with healthy non-diabetic subjects. Study Design: A retrospective analytical study. Place and Duration of Study: This study was conducted at the Army Medical College, Rawalpindi during the period from 2004 to 2006. Materials and Methods: This study was conducted on TIDM, T2DM, DKA and HHS patients and monitored insulin level, plasma osmolality, serum electrolytes and arterial blood gases levels revealed that the clinical records and data confirmed and described each event and its likely causes. Results: Ketoacidosis was frequently seen among persons with type 1 diabetes with marked hypoinsulinemia, hyperkalemia and acidosis.  Hyperinsulinemia, acidosis and hyperosmolality were the significant finding in HHS. Conclusion: The observed association between insulin level and pretreatment metabolic and acid base derangements were statistically highly significant.