DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20164553

Clinico-social parameters of diabetes among patientsutilizing emergency medical services

Rajhans Prasad A., Kulkarni Priya Y., Kelkar Dhananjay S., Jog Sameer A., Ranade Gouri, Utpat Sonal, Hande Varsha

Abstract


Background: Diabetes mellitus (DM) is increasing in its potential in developing countries. Rise in diabetic patients calling emergency medical services (EMS) is expected. It calls for thorough assessment of patients with DM utilizing EMS. In the present study, was to assess magnitude of DM among patients utilizing EMS and its clinico-social parameters.

Methods: It was hospital record based observational study of patients calling EMS delivered by a tertiary care hospital in Pune, Maharashtra, India during 1st January 2013 to 31st December 2014. Patients with incomplete records were excluded. A person with medical background was trained to extract required information from hospital records. Patients with previously diagnosed DM were considered those who were on diet, oral hypoglycemic agents or taking insulin therapy and newly diagnosed patients with DM were considered those with the value of glycemia on admission >200 mg/dl in first 24 hours. Data analysis was done using SPSS 15.0 software.

Results: 45.8% (894/1951) were Patients with DM out of that 78.19% (699/894) were known to have DM while 28.81% (195/1951) were new cases of DM. 5.1% (100/1951) patients had uncontrolled DM. DM was significantly more in >60 years age group and in urban residents (p<0.001). Patients with DM were significantly more to have breathlessness, altered sensorium and dyspnoea as major purpose to call EMS (p<0.001, <0.001 and 0.045 respectively). Other co-morbidities in the form of Hypertension, other cardiovascular abnormalities, COPD, CKD and history of CVA were significantly more among Patients with DM (p<0.001, except for COPD, p=0.027).

Conclusions: There was a high burden of patients with DM on EMS. EMS teams should be well trained to diagnose and manage such emergencies. Mass awareness of screening for DM and its proper management will help to decrease such burden.

Keywords


DM, EMS

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References


Gupta M, Singh R. Diabetes in India: a long way to go. Int J Sci Rep. 2015;1(1):1-2.

Gandhi NF, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon). 2014;42(12):698-702.

Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014;7:45-8.

Mohan V, Madan Z, Jha R, Deepa R, Pradeepa R. Diabetes-social and economic perspectives in the new millennium. Int J Diab Dev Ctries. 2004;24:29-35.

International Diabetes Federation. IDF Diabetes, 7 ed. Brussels, Belgium: International Diabetes Federation, 2015. http://www.diabetesatlas.org

Joshi SR. Rising prevalence of diabetes in urban india. Lancet diabetes endocrinol. 2014:2(1);56-64.

Deshpande AD, Hayes MH, Schootman M. Epidemiology of Diabetes and Diabetes-Related Complications Phys Ther. 2008;88(11):1254-64.

Raj X. Saving lives through rural ambulance services: Experiences from Karnataka and Tamil Nadu states, India. Transport and Communications Bulletin for Asia and the Pacific. 2014:84;52.

Stojkovic A, Tomašević M, Krstić N, Perišić Z, Pavlović M, Šalinger-Martinović S, et al . The effect of stress induced-hyperglycemia on hospital treatment outcome in patients with acute myocardial infarction with st segment elevation. Acta Medica Medianae. 2012:51(3).

Zimmet PZ. The growing pandemic of type 2 diabetes: a crucial need for prevention and improved detection. Available from http://www.medicographia.com/ 2011/07/.

World Diabetes 2015. The Eye-opening Reality of Diabetes in India. Anoop Misra, Director, Diabetes and Metabolic Diseases, Diabetes Foundation (DFI India), Modified: November 14, 2015 11:53 IST. Available from: http://food.ndtv.com/ health/ world-diabetes-2015.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007:125;217-30.

Radha V, Mohan V. Genetic predisposition to type 2 diabetes among Asian Indians. Indian J Med Res 2007;125(3):259-74.

Hu FB. Globalization of Diabetes: The role of diet, lifestyle, and genes. Diabetes Care. 2011;34(6):1249-57.

Gupta M, Singh R. Diabetes in India: a long way to go. Int J Sci Rep. 2015;1(1):1-2.

Global Forum Health. Risk factor surveillance for non-communicable diseases (NCDs): the multi-site ICMR-WHO collaborative initiative, 2015. Available at: http://www.globalforumhealth.org/.

Piette JD, Kerr EA. The Impact of Comorbid Chronic Conditions on DM Care. DM Care. 2006:29(3):725-31.

Joshi SR, Saboo B, Vadivale M, Dani SI, Mithal A, Kaul U, et al. Prevalence of diagnosed and undiagnosed diabetes and hypertension in India-results from the Screening India's Twin Epidemic (SITE) study. Diabetes technology & therapeutics. 2012;14(1):8-15.

Spranger J, Kroke A, Möhlig M, Hoffmann K, Bergmann MM, Ristow M, et al. Inflammatory cytokines and the risk to develop type 2 diabetes: results of the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Diabetes. 2003;52(3):812-7.

Hu FB, Meigs JB, Li TY, Rifai N, Manson JE. Inflammatory markers and risk of developing type 2 DM in women. DM. 2004;53:693-700.

American Heart Association. Cardiovascular disease and DM. Reviewed August 2015. Available from p://www.heart.org/HEARTORG/Conditions/DM.

Kearney T, Dang C. Diabetic and endocrine emergencies. Postgrad Med J. 2007;83(976):79-86.

Augustine J. DM: The highs, lows and “When can they Go’s”. Available form [www .ems1.com], Accessed on 1st August 2011.