Diabetic coma in the mortality of patients with diabetes mellitus

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Abstract

BACKGROUND: Statistics on the causes of death of patients with diabetes mellitus do not correspond to real indicators because of the insufficient level of diagnosis at the post-mortem stage of research in most regions of the country.

AIM: This study aimed to statistically analyze the mortality of patients with diabetes as a result of diabetic coma in the period from 2017 to 2020.

MATERIALS AND METHODS: The study examined blood and vitreous body of the eyes from 4444 patients with diabetes mellitus. The levels of glycohemoglobin in the blood and glucose, lactate, and acetoacetate in the vitreous body of the eyes were determined. The diagnosis of diabetic coma was made taking into account previously developed criteria.

RESULTS: A total of 692 (15.6%) patients with diabetes mellitus died of diabetic coma. Diabetic coma-related deaths occupy a much larger percentage of cases than is available in statistical data because of the insufficient implementation of laboratory tests at the post-mortem stage of diagnosis and restricted coding of the cause of diabetic coma-related death of patients with diabetes mellitus. Methods for diagnosing diabetic comas are easy to perform, guarantee high accuracy and reliability of results, and are available for any specialized laboratory.

CONCLUSION: The most common precomatous state (the beginning of the development of hyperosmolar non-ketoacidotic coma), which in combination with coma itself, leads to the highest rates of diabetic coma-related death. In recent years, diabetic coma-related death tended to reduce.

About the authors

Pavel A. Akimov

E.A. Vagner Perm State Medical University; Perm Regional Bureau of Forensic Medical Examination

Email: p.a.akimov@yandex.ru
ORCID iD: 0000-0003-4347-8760
SPIN-code: 9597-4566
Scopus Author ID: 56426895500

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Perm; Perm

Evgeny K. Barinov

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: ev.barinov@mail.ru
ORCID iD: 0000-0003-4236-4219
SPIN-code: 2112-4568

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Natalya A. Terekhina

E.A. Vagner Perm State Medical University

Author for correspondence.
Email: terekhina@list.ru
ORCID iD: 0000-0002-0168-3785
SPIN-code: 7663-4110
Scopus Author ID: 7004162006

MD, Dr. Sci. (Med.), Professor

Russian Federation, Perm

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Structure of diabetic comas and 95% confidence interval: (along the abscissa axis) 1 ― diabetic precoma, 2 ― hyperosmolar non-ketoacidotic coma, 3 ― hyperosmolar ketoacidotic coma, 4 ― ketoacidotic coma, 5 ― hypoglycemic coma; (on the ordinate axis) the proportion of occurrence of diabetic com (%).

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