title: Correlation between peripheral white blood cell counts and hyperglycemic emergencies.
abstract: OBJECTIVE
  To determine the correlation between differential leukocyte counts and hyperglycemic emergencies.
  
  
  METHODS
  Fifty patients with diabetic ketoacidosis (DKA), 50 patients with diabetic ketosis (DK), 50 non-DK diabetic patients with stable glycemic control, and 50 normal controls were enrolled. Their total and differential leukocyte counts were measured and evaluated at admission and after treatment.
  
  
  RESULTS
  The patients with DKA and DK had higher plasma glucose levels (20.84±6.73 mmol/L, 15.55±2.6 mmol/L, respectively) and more median leukocytes (13325/mm(3) and 6595/mm(3), respectively) and median neutrophils (11124 /mm(3) and 4125/mm(3), respectively) but fewer median eosinophils (28/mm(3) and 72/mm(3), respectively) compared to non-DK and control groups (all p < 0.05). Acute infection increased the elevating extent. The median leukocyte counts in DK and non-DK patients (6595/mm(3) and 6008/mm(3), respectively) were within the normal range. The counts of total leukocytes and neutrophils were significantly higher but eosinophils lower in severe DKA cases than in mild/moderate cases (p < 0.05). When the DKA and DK and infection resolved, total leukocytes and neutrophils fell, but eosinophils increased. The counts of total leukocytes, neutrophils, and monocytes were negatively correlated with arterial pH levels (r = -0.515, r = -0.510, r = -0.517, all p < 0.001, respectively) and positively correlated with plasma glucose levels (r = 0.722, r = 0.733, r = 0.632, all p < 0.05, respectively) in DKA patients. The arterial pH level was the most significant factor affecting total leukocytes in DKA (β = 0.467, p = 0.003). The diagnosis analysis showed that higher total leukocyte and neutrophil counts and lower eosinophil counts had a significant ability to reflect the presence of hyperglycemic emergencies.
  
  
  CONCLUSIONS
  More total leukocytes and neutrophils but fewer eosinophils was significantly correlated with DKA and DK. Leukocyte counts can add valuable information to reflect the presence of hyperglycemic crisis and acute infection.
authors: School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China.
authors: Wei
authors: W
authors: Xu
authors: Hai-feng
authors: HF
authors: Wu
authors: Shao-gang
authors: SG
authors: Ma
authors: Feng
authors: F
authors: Bai
authors: Wen
authors: W
authors: Hu
authors: Yue
authors: Y
authors: Jin
authors: Hong
authors: H
authors: Liu
mesh_terms: D000328:Adult; D001786:Blood Glucose; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000473:pathology / Q000628:therapy*; D004630:Emergencies; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000473:pathology / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology; D009504:Neutrophils / Q000166:cytology
chemical_list: D001786:Blood Glucose
keywords: Diabetic ketoacidosis; Diabetic ketosis; Leukocytes counts.
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