Hospitalizations during a Month of Emergency in a Department of Diabetology

Introduction: Tunisia is not immune to the heavy expenses related to diabetes, especially the cost of hospitalization. The aims of the work were to evaluate the number of hospitalizations in a diabetes unit during an emergency month and to study the indications of these hospitalizations.

Material and methods: Our work is a retrospective, descriptive study, performed in the department C of the National Institute of Nutrition and Food Technologies of Tunis. The patients included in our study had all consulted the dispatching of the Institute during October 2017 and carried the indication to emergency hospitalization.

Results: The number of patients hospitalized was 90. The majority was female(72.2%). The mean duration of hospitalization was 5.3±2.8 days (from 3 to 21 days). The mean age was 39.8±4.7 years (from 16 to 81 years). The indications for hospitalization were as follows: acid-ketotic decompensation in 4.4%(n=4); ketotic decompensation in 14.4%; hyperosmolarity in 4.4%; diabetic foot in 5.6%; unstable diabetes in 7.8%; unbalanced diabetes in 22.2%; discovery of gestational diabetes in 21.1%; pregnancy and unbalanced diabetes mellitus in 16.7% and exploration of hypoglycaemia in a nondiabetic patient in 3.3%. The imbalance or decompensation factors for diabetes were lipodystrophy in 38.9%; drug and/or dietary non-compliance in 46.7%; an infection in 21.1%; insulin resistance in 16.7% and the absence of fast insulin bolus in 7.8%. As for hypoglycaemia in nondiabetics (n=3), two cases were confirmed and these were functional hypoglycaemias. The third case reversed was addressed in neurology and cardiology for exploration of discomforts.

Conclusions: The main indication of emergency hospitalization was decompensated or unbalanced diabetes with lipodystrophies and poor adherence as the main causes. This underscores the importance of the repetition of education sessions for diabetic patients and the psychological care of them.