Lasting mortality risk increase with hyperglycemic crises

(HealthDay)—During the first six years of follow-up, geriatric patients with diabetes have a higher mortality risk after hyperglycemic crisis episode (HCE), according to a study published in the May issue of Diabetes Care.

Chien-Cheng Huang, M.D., from the Chi Mei Medical Center in Taiwan, and colleagues delineated long-term mortality risk after HCE using data from 13,551 geriatric patients with new-onset diabetes between 2000 and 2002. A total of 4,517 patients with HCE (cases) and 9,034 without HCE (controls) were followed through 2011.

The researchers found that 36.17 percent of case subjects and 18.73 percent of controls died during follow-up (P < 0.0001). The incidence rate ratios (IRRs) of death were significantly higher (2.82-fold) in cases (P < 0.0001). In the first month, mortality risk was highest (IRR, 26.56), and the increased risk persisted until four to six years after HCE (IRR, 1.49). The mortality ratio was 2.848 and 4.525 times higher in case subjects with one episode or two or more episodes of hyperglycemic crisis, respectively, after adjustment for age, sex, selected comorbidities, and monthly income. Independent mortality predictors included older age, male sex, renal disease, stroke, cancer, chronic obstructive pulmonary disease, and congestive heart failure.

"Referral for proper education, better access to medical care, effective communication with a health care provider, and control of comorbidities should be done immediately after HCE," the authors write.