Blood glucose and neurological status: dual predictors of survival in diabetic emergency

Background: Acute diabetic emergencies, including diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic syndrome (HHS), and hypoglycaemia, require urgent medical intervention. These complications result from severe metabolic disturbances, often causing neurological impairment. Blood glucose levels measure metabolic derangement, while the Glasgow Coma Scale (GCS) indicates cerebral dysfunction. Objectives: This study evaluates the prognostic significance of blood glucose levels and GCS in predicting survival rates among diabetic emergency patients, hypothesizing that these parameters are robust outcome indicators. Methods: A retrospective cross-sectional study analysed medical records of ۲۵۰ patients treated for diabetic emergencies at Dr. Soedono General Hospital Madiun (۲۰۱۷–۲۰۲۴). Blood glucose levels and GCS scores were assessed using chi-square tests (p < ۰.۲۵) and multivariate binomial logistic regression (p < ۰.۰۵) in SPSS version ۲۱. Results: Multivariate analysis identified GCS as the most critical survival predictor, with low GCS scores significantly correlating with mortality (OR = ۰.۰۰۲, ۹۵% CI: ۰.۰۰۰–۰.۰۱۲, p < ۰.۰۵). Blood glucose levels >۶۰۰ mg/dL were also associated with reduced survival rates (OR = ۰.۱۱۳, ۹۵% CI: ۰.۰۷۴–۴.۳۰۴, p < ۰.۰۵). The model explained ۷۲.۱% of the variance in patient outcomes. Conclusion: GCS and blood glucose levels are pivotal survival predictors in diabetic emergencies, with GCS being the predominant determinant. These findings highlight the importance of early neurological evaluation and glucose regulation in improving outcomes.

کلیدواژه ها:

Diabetic ketoacidosis ، Glasgow Coma Scale ، Hyperosmolar hyperglycemic syndrome ، Blood glucose ، Emergency care