Clinical profile and outcome of hyperglycaemic emergencies at a rural hospital in southern Nigeria

We have documented the clinical pattern of hyperglycaemic emergencies (HGEs) and predictors of outcome at a tertiary hospital in a rural setting in Nigeria. In a 2-year retrospective review, we identified 88 patients with HGEs. Fifty-four (61%) were females, and mean age was 55 years. Forty-seven (53%) had hyperglycaemic hyperosmolar states (HHS), 34 (39%) had diabetic ketoacidosis (DKA), and 7 (8%) had a mixed type of HGE. The commonest precipitating factor was infection and was seen in 39 (44.3%) patients; 28 (32%) were newly diagnosed with diabetes. The mortality rate overall was 34% and the case fatality rate of DKA, HHS, and mixed-type HGE was 23%, 38%, and 57% respectively. Elevated urea was a predictor of poor outcome; while age, gender, and the presence of chronic diabetes complications were not predictors of outcome. We conclude that the mortality rate in HGEs is high, and that elevated urea is a predictor of poor outcome.Effective diabetes education, prompt recognition of symptoms, and treatment of metabolic derangements in HGEs may reduce morbidity and mortality

Trace mineral status and glycaemic control in Nigerians with type 2 diabetes

Diabetes has been shown to be associated with abnormalities in the metabolism of micronutrients, especially chromium, zinc, copper, magnesium, and manganese. People with type 2 diabetes attending the Diabetes Clinic of the University of Benin Teaching Hospital, were recruited to examine the relationship between trace mineral status and glycaemic control. A total of 120 persons were studied, mean (±SD) age was 54±7 years and mean duration of diabetes 4±4 years. Serum chromium level correlated inversely with fasting blood glucose (FBG) and HbA1c, unlike the serum concentration of zinc which had no significant correlation with either FBG or HbA1c. People with diabetes should be encouraged to eat local specific foods rich in chromium