Seasonality in hyperglycemic emergencies in a Health Facility in Sub-Saharan Africa: The roles of geographic location, infection, and knowledge of diabetes mellitus status

Abstract

Hyperglycemic emergencies (HEs) are acute complications of diabetes mellitus and they carry high morbidity and mortality. Studies have reported a seasonal pattern in the frequency of occurrence of both types 1 and 2 diabetes mellitus and even Gestational Diabetes Mellitus. No such association has been suggested for HEs. The study was conducted at the Asokoro District Hospital, Located in Abuja, Nigeria to examine a seasonal pattern in the frequency of hyperglycemic emergencies. The initial observation of an obvious fluctuation in the number of admitted cases of hyperglycemic emergencies motivated this prospective study which ran for a period of six years. It involved collecting the relevant information using a questionnaire from all HEs patients admitted to the medical ward from the first of January, 2008 to the 31st of December, 2013. Required investigations were done. The precipitating factors for HEs were looked for. The number of cases per month was noted for each year. The Statistical package used for analysis was STATA version 11. Round the year Abuja Climatic changes were monitored on the website of the Nigerian Meteorological station. Four hundred and fifty-one (451) patients with hyperglycemic emergency were enrolled for this study. Most of the patients, (55%), were in the middle-age bracket. Fifty-six per cent (56%), were not previously known to be living with diabetes mellitus. Infections, particularly of the respiratory and gastrointestinal tracks, were the commonest precipitating factors. Variation in the frequency of HEs was observed, with two peaks: one in April and a smaller peak in December. There is seasonal variation in the frequency of presentation of Hyperglycemic emergencies. This may have been influenced by exogenous factors such as geographic location, infection, and the fact that most of the patients never knew they had diabetes mellitus.