Old lady with untreated diabetes, facing a series of complications

(CTO) - Old lady VT Đ (77 years old, in Vung Liem district, Vinh Long province) did not know she had diabetes, so she did not treat it, leading to many life-threatening complications.

Through testing, doctors at Hoan My Cuu Long General Hospital discovered that the old woman's blood sugar index was very high, at 830mg/dl, more than 8 times higher than normal people (normal blood sugar index is from 70 - 100mg/dl).

When admitted to the emergency room, the old lady had symptoms of fever, cough, vomiting, poor appetite, fatigue, lethargy, slowness, dry skin, collapsed neck veins, low blood pressure 90/60mmHg. The old lady had a history of high blood pressure and spinal degeneration but did not go to the doctor, and bought medicine to take on her own.

Doctor examines the old woman before discharge. Photo: BV

After examination, the doctor diagnosed that the old lady had acute hyperglycemia, hyperosmolarity/type 2 diabetes, hypertension, myocardial ischemia, Cushing's syndrome, acute kidney injury, electrolyte disturbance, osteoporosis, and gastritis.

Immediately afterwards, the patient was consulted at level 2 and quickly transferred to the Intensive Care and Anti-Poison Department for active treatment, fluid replacement according to the protocol, blood sugar control with insulin via an electric syringe, bicarbonate replacement, general condition improvement, and hourly monitoring of blood sugar, urine, and electrolytes.

After 2 days of treatment, the patient was alert, no longer vomiting, able to eat and drink, less thirsty and urinating frequently, blood sugar gradually stabilized and was transferred to the Endocrinology Department for further treatment.

At the Endocrinology Department, the patient was switched from intravenous insulin (electric syringe) to subcutaneous injection, fluid replacement, and stable condition assessment. The old lady has now been discharged from the hospital and is being followed up for outpatient check-ups, with parameters of blood sugar, liver and kidney function, electrolytes, and hemodynamics returning to normal.

Dr. Lam Thanh Danh, Deputy Head of the Department of Endocrinology, Hoan My Cuu Long General Hospital, said: This is a typical case, detecting diabetes in the context of acute complications, in a patient with previously undiagnosed diabetes, with a high risk of death if not promptly treated. The old lady had a chronic disease, instead of going to the doctor and being treated for related diseases, she bought medicine on her own for a long time, causing the disease to be detected late, causing many acute complications.

Dr. Danh also recommends that the elderly (over 65 years old) with chronic diseases should not buy medicine on their own but should go to the hospital for timely diagnosis and treatment and screening for related diseases. Diabetic patients need to strictly follow the doctor's treatment regimen, have regular check-ups and screening for complications, and should not arbitrarily stop taking insulin injections and oral medications.

For people with diabetes, when they see unusual signs while taking medication, they need to go to a medical facility immediately for a re-examination and medication adjustment. In addition, people at high risk of diabetes must follow a reasonable diet, exercise regularly, and especially have regular screening every 6-12 months at medical facilities to detect the disease early and complications of diabetes.

AUTUMN DEW

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