Management of Severe Hyperglycemia with Associated Pulmonary Oedema, Due to Coronary Disease

Abstract

Introduction:

Diabetes Mellitus, a leading public health problem has a profound effect on Cardiovascular system and majority of the mortality and morbidity from diabetes is related to Cardiovascular dysfunction. The management of such patients is challenging clue to their precarious metabolic status and the precision required in adjusting their insulin dose, as reduction of hyperglycemia may be disastrous.

Material & Methods:

We present here a study of 11 COflSCCUt1VC diabetic patients treated in medical unit III in the past two months, who were admitted from emergency room in pulmonary edema (LVF) with or without acute myocardial infarction and were severely hyperglycemic (blood sugar> 400 mg %) at the time of admission. Patients were managed on the low dose insulin therapy regime for hyperglycemia on the pattern of the protocol of the American Diabetic Association. (Table I).

Results:

From the result of the study which is presented in tabulated form (Table II), the following observations can he made. Age :- The age range was from 44-68 years with a mean of 54 years.  Female patients were of younger age with a mean of 50 years in contrast to the male mean age of 59.4 years. Sex:- There was a preponderance of female over male 6:5. Cause of LVF: Only 3 out of 11 patients (27.2 %) presented with left ventricular failure resulting from acute myocardial infarction. The rest