title: Clinical characteristics of hyperglycemic crises in patients without a history of diabetes.
abstract: OBJECTIVE
  Hyperglycemic crises without a history of diabetes have not been well studied. We compared the clinical characteristics of patients with and without a history of diabetes, and evaluated the glycated hemoglobin levels.
  
  
  METHODS
  Consecutive adult patients (aged >18 years) visiting the emergency department (ED) between January 2004 and December 2010 were enrolled if they met the criteria for a hyperglycemic crisis. Patients were separated into those without and those with a history of diabetes. The 30-day mortality was the primary end-point.
  
  
  RESULTS
  We enrolled 295 patients who made 330 visits to the ED. Patients without a history of diabetes made up 24.5% (81/330) of the hyperglycemic crises. Patients without a history of diabetes were more prone than patients with a history of diabetes to be younger and male, and to have better consciousness and renal function, more significant diabetic signs and symptoms (e.g., thirst, polydipsia, polyuria and bodyweight loss), higher blood sugar, and less opportunity of infection and mortality. Most of the patients (93.8%, 76/81) had glycated hemoglobin of ≥6.5%.
  
  
  CONCLUSIONS
  The present study delineates the clinical characteristics of patients with hyperglycemic crises, but without a history of diabetes. Most patients had glycated hemoglobin ≥6.5%, which raises the argument of using this biomarker for routine screening of diabetes.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Tainan, Taiwan ; Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science Tainan, Taiwan.
authors.forename: Willy
authors.initials: W
authors.lastname: Chou
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center Tainan, Taiwan ; Department of Emergency Medicine, Chi-Mei Medical Center Liouying, Taiwan.
authors.forename: Min-Hsien
authors.initials: MH
authors.lastname: Chung
authors.affiliation: Department of Nephrology, Chi-Mei Medical Center Tainan, Taiwan ; Department of Sport Management, College of Leisure and Recreation Management Tainan, Taiwan.
authors.forename: Hsien-Yi
authors.initials: HY
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Cathay General Hospital Taipei, Taiwan ; Fu Jen Catholic University School of Medicine Taipei, Taiwan.
authors.forename: Jiann-Hwa
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Cathay General Hospital Taipei, Taiwan ; Fu Jen Catholic University School of Medicine Taipei, Taiwan.
authors.forename: Wei-Lung
authors.initials: WL
authors.lastname: Chen
authors.affiliation: Department of Environmental and Occupational Health, Medical College Tainan, Taiwan ; Department of Occupational and Environmental Medicine, National Cheng Kung University Tainan, Taiwan.
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center Tainan, Taiwan ; Department of Biotechnology, Southern Taiwan University of Science and Technology Tainan, Taiwan ; Department of Emergency Medicine, Taipei Medical University Taipei, Taiwan.
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.affiliation: Department of Occupational Medicine, Chi-Mei Medical Center Tainan, Taiwan ; Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology Tainan, Taiwan ; Department of Medical Research, Chi-Mei Medical Center Liouying, Taiwan.
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center Tainan, Taiwan ; Department of Child Care and Education, Southern Taiwan University of Science and Technology Tainan, Taiwan.
authors.forename: Chien-Cheng
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center Tainan, Taiwan ; Department of Biotechnology, Southern Taiwan University of Science and Technology Tainan, Taiwan.
authors.forename: Chien-Chin
authors.initials: CC
authors.lastname: Hsu
keywords: Hyperglycemic crisis; Mortality; New-onset