Screening Of Acute And Chronic Diabetic Complications Among A Cohort Of Diabetic Patients Admitted To Intensive Care Unit

The present study included two hundreds and fifty patients admitted to intensive care units of the main University Hospital of Alexandria. All patients had diabetes mellitus whether diabetes is the primary or secondary cause for admission. There are 148 females (59.2%) and 102 (40.8%) male patients. The age of these patients varies from 9 to 85 years with a mean 49.55 +/- 17.46 years. 80.4% of the patients were type 2 DM and 19.6% were type 1 DM. Aim of the work: was to determine the prevalence of acute and chronic diabetic complications among 250 diabetic patients admitted to the Intensive Care units of the Alexandria main University Hospital. Subjects and methods: All patients were subjected to thorough clinical examination including: Complete history taking, laying stress on the duration of diabetes, treatment given to control diabetes and the occurrence of the different complications of diabetes. Complete general examination, laying stress on the cardiovascular system, chest examination, abdominal examination, and examination of peripheral nervous system. Laboratory investigation especially: Random blood glucose. Serum creatinine, blood urea nitrogen. Serum cholesterol, serum TG. urinary albumin excretion rate. Electrocardiogram. Fundus examination by direct ophthalmoscope. Result: The result of the present study can be summarized as follow: 95.6% of patients are suffering from one or more of the diabetic complications. Either acute in 30.8% or chronic in 81.2% DKA was the most frequent acute complication accounting 23.6% of these complications. It occurred mostly in type 1 diabetes and to lesser extend in type 2 diabetes. Diabetic neuropathy was the most common chronic complications accounting for 56% of complications; somatic peripheral neuropathy is the commonest type of diabetic neuropathy, in our study the incidence of somatic neuropathy was 52.8% and autonomic neuropathy was 10%, most of patients suffering from autonomic neuropathy were having in the same time somatic neuropathy. Followed by diabetic nephropathy (41.2%), cardiovascular complications (34.8%), diabetic retinopathy (32.8%), diabetic foot (25.2%), 59 cases have DKA (23.6%), 37 cases have CVS (14.8%). There was positive correlation between BMI and increase in serum cholesterol and serum TG. DKA was significantly higher in patients with type 1 diabetes than those with type 2 diabetes. Diabetic neuropathy, nephropathy, retinopathy, cardiovascular and diabetic complications were significantly higher in type 2 diabetes than type 1 diabetes. There was negative correlation between DKA and duration of diabetes. But, there was positive correlations between duration of diabetes and retinopathy, neuropathy, foot complications, cardiovascular and cerebrovascular complications. There was significant impact present of some metabolic variants like hyperglycemia, HTN and hyperlipidemia on the development of different complications. Also the effect of the body weight (BMI) and its positive correlation with these variables. There is positive correlations between all diabetic complications and blood pressure, RBG, serum cholesterol, and serum TG. [Fathy Z. El-Sewy(1), Abla A. Abou-Zeid(2), Tamer A. Helmy(3), Amr F. Abou-Alkhair(4) and Soha S. A. El baz. Screening Of Acute And Chronic Diabetic Complications Among A Cohort Of Diabetic Patients Admitted To Intensive Care Unit. Life Science Journal, 2011; 8(4): 719-732] (ISSN: 1097-8135). http://www.lifesciencesite.com.