STUDIES ON DIABETES AND DIABETIC COMA IN ISFAHAN

Abstract

During a six year period (1969-1974), 29,233 records of the hospital admissions were carefully reviewed from the standpoint of age, sex incidence, precipitating factors, method of treatment and results in diabetes and diabetic coma patients in the Isfahan University Medical School’s hospitals. Two hundred and fifty cases of diabetic patients were found (0.8% of the total), from which 25 (8%) were in coma upon admission. From these 250 cases, 66% had maturity onset diabetes and 34% the juvenile type of diabetes. Approximately 84% of the comatose patients were in the keto acidosis prone group with preponderance in the female, where as the other 16% of the patients were in the maturity onset type of diabetes mellitus category. The average period between the clinical onset (the signs and symptoms) and the chemical diagnosis of diabetes in this study was a 44 month interval. The mean fasting blood sugar in 78.2% of the total diabetic and 92% of the comatose diabetics was above 200 mg%. The residential location of the diabetic patients were principally (80%) in the Isfahan city area, in contrast to the diabetic coma patients who were mostly from the suburbs of Isfahan. The precipitating factors, in those comatose patients, were infection, gastroenteritis and mainly patients’ negligence to take their insulin. All of the patients in keto-acidotic coma with the exception of three, required on the average, less than 200 units of regular insulin and around 4,000 milliliters of I.V. fluids within the first 24 hours of admission to recover. The remaining three or 12% who had dehydration and irreversible electrolyte imbalance, died shortly after arrival at the hospital.