Abstract

Thirty two cases of acute metabolic complication in diabetic patints who were admitted to Yonsei Medical Center., Serverance Hospital from Janary, 1976 to December, 1980 were studied and the following reaults were obtained. Durivg the same period, the total in-patients were 105,962 and diabetic patients 2, 744(2. 6%). Among these diabetic patient.cases of acute metabolic complication were 32(1.16%), DKA 21 cases, HNC 10 cases and lactic acidesis 1 case. There was no sex difference in prevalance, and the mean age were 33.3 in DKA and 58.9 years in HNC. 3.The chief complairits on admidssion were merital change(46,9%),non-specific G-I symptoms (15.6%) generaI weakness (12,5%), respiration abnormality(12.5%) seizure and dehydration. 4.The phsical findings on admission were severe dehydration (90.6%), changes of mental status(84, 4%). KussnauI's respiration(43.8% ), abdominal tenderness, hepatomegay, and, neurologic deficit. 5. The precipitating factors were infection (28.1%), physical stress(25%), omission of insulin (18.8%), G-l and emotional upsets and alcohol or drug ingestion. 6.The mean plasma glucose levels on admission were 643.8 +-106.3 in DKA and 956.6+-445.3mg% in HNC. The mean serum sodium levels were 124.4+-39.6 and 153.4 +- 12.1mEq/L ,potassium 5.4+-0.9 and 4.6+-1.14 mEq/L ,CO'' contest 7.0+-3.8 and 23+-6.1 Mm/l, serum esmolarity 307.2 +-21.9 and 369.4+-12.2 mOsm/kg in DKA and HNC respectively. 7.The total doses of regular insulin required for initial 24 hours after admission were less than 50 units in 17 cases (53.1%), 51 to 100 units in 12 cases(37.5%), and 101 to 150 units in remaining 3 cases(9.4%). 8. The moratality rates of DKA and HNC were 14.3% and 50% respectively. The causes of death were underlying diseases (37.5%), sepsis (25%) and electrolyte imbalance (25%) death due to insulin hypoglycemia.