The Incidence of Electrolytes and Acid-Base Abnormalities in Diabetic Emergencies using the I-Stat Portable Analyser.

Abstract

Diabetic patients with prolonged insulin insufficiency can present in the emergency department with life threatening ketoacidosis,el ectrolyte abnormalities,an d morbid arrhythmias. A quick and accurate determination of the metabolic abnormalities with rapid intervention is paramount in their management. The aim of this study was to determine the incidence of electrolyte and acid-base abnormalities in diabetic emergencies using the I-STAT point of care testing technique. The study involved thirty diabetic patients admitted into the accident and emergency department of the Lagos University Teaching Hospital. Informed consent was obtained from all participants. Blood samples were obtained for estimation of electrolytes and acid-base using point of care testing (I-Stat portable analyser). A Multistix urine strip (Bayer Diagnostics Reagent Strips) was used for urine analysis to detect the presence of ketones. The mean age was 60.37 ±10.45 (40-79) years, made up of 21(70%) females and 9(30%) males, with a mean duration of diabetes mellitus of 6.5 ±3.56 years. Hyperglycaemia was observed in 70%, and hypoglycaemia in 20%.T he commonest electrolyte abnormality was hypokalaemia (56.67%)followed by hyponatremia (50%).Other abnormalities included hyperkalaemia (10%) and hypernatremia (3.3%). Abnormalities of acid base balance included low pH (20%), low TCO₂ (16.67%), high TCO₂ (16.67%), high PCO₂ (46.67%),and low PCO₂ (23.33%). The results indicated that in diabetic emergencies the commonest electrolyte abnormality was hypokalaemia followed by hyponatremia, and the least was hypernatremia.

Key words: Diabetes mellitus, I-stat portable analysers, electrolyte and acid-base abnormalities