By Miss Jitjira Chaiyarit ID: 567110015-4 The association between eGFR and Hyperosmolar Non-Ketotic Hyperglycemia Syndrome in Diabetes type 2 Doctoral

ByByMiss Jitjira ChaiyaritMiss Jitjira Chaiyarit

ID: 567110015-4ID: 567110015-4

The association between eGFR The association between eGFR and Hyperosmolar Non-Ketotic and Hyperosmolar Non-Ketotic

Hyperglycemia Syndrome in Hyperglycemia Syndrome in Diabetes type 2Diabetes type 2

Doctoral Seminar 1 / 2013

OutlineOutline

•Introduction

•Materials and Methods

•Results

•Discussion


IntroductionIntroduction

Hyperosmolar Non-Ketotic Hyperglycemia Syndrome (HNHS) is a life-threatening complication of uncontrolled diabetes mellitus and often found in patients with type 2 diabetes, is a serious condition

most frequently seen in older persons.

Complications associated with HHNS include severe metabolic disturbances, renal impairment etc. The testing of kidney working is an uncommon complication of HNHS but probably subclinical and thus underestimated.


Materials and MethodsMaterials and Methods

The design was Cross-sectional analytical.

The information for analysis was part of DM&HT dataset.

The sampling method was stratified cluster sampling with probability proportional to size hospitals

The exclusion criteria were:i)under age of 18

ii)not been examined serum creatinine

iii)were diagnosed with HT or both DM & HTDoctoral Seminar 1 / 2013

Materials and Methods (Cont.)Materials and Methods (Cont.)

The main outcome was HNHS (yes, no)

The factor of interest was eGFR that was

recalculated by CKD-EPI formulas

Covariate were gender, age, receiving ACEI

or ARB and HbA1CDoctoral Seminar 1 / 2013

Stages of kidney disease eGFRStage 1-2 ≥ 60

Stage 3 30-59

Stage 4-5 ≤ 29


Statistical analysis:

i)The continuous variables were presented

as mean and standard deviation.

ii) The categorical variables were presented

as frequency and percentage.

iii) Logistic regression models were used to

examine association and OR.



• Ethical Consideration

The permission to study was granted by each of sampled hospitals. Obtaining written informed consent of all participating patients was done prior to access to their medical records. Data collection was done by participating hospital’s authorized skilled personnel who had been trained to protect and deliberately engaged in the study.




• Research frame

ResultsResults

Baseline Characteristics

•eGFR (n=24,133)


Mean(SD) = 84.22 (24.44)(mL/minute/1.73m2)

Results (Cont.) Results (Cont.)

Baseline Characteristics (Cont.)


• Gender (n= 24,263) • Age (n= 24,245)

Mean(SD) = 56.09 (10.90)(year)


Baseline Characteristics (Cont.)


• Receiving ACEI or ARB (n= 19,162)

• HbA1C (n= 17,653)


Factors associated with HNHS



Factors associated with HNHS adjusted for all other factors


DiscussionDiscussion

•The study found statistically significant

association between eGFR and HNHS.

•The present result found the patients with low

eGFR had risk effect (adj.OR=2.89) for having

HNHS. This is consistent with a previous finding

that if renal function declined, it was cause of

glucosuria that was a risk factor for HNHS.


Discussion (Cont.)Discussion (Cont.)

•From result, age was protective effect

(adj.OR=0.80) that contrasts with research in the

past which found the average age of patients

with HNHS is 60 years. In the other hand, the

previous research has demonstrated that

HNHS may also occur in younger people.


Discussion (Cont.)Discussion (Cont.)

•The patients who had poor glycemic control

(HbA1c ≥ 7%) were at greater risk (adj.OR=2.01).

This finding suggests that in those who have

not been able to control their diabetes, HNHS

will occur. This result supports past studies

show that the patients were poor management

if blood sugar levels rise and left untreated,

this can result in diabetic coma and death.


Thank youThank you

for your attention.for your attention.

Documents

By Miss Jitjira Chaiyarit ID: 567110015-4 The association between eGFR and Hyperosmolar Non-Ketotic Hyperglycemia Syndrome in Diabetes type 2 Doctoral