Despite advances in treatments for
diabetes mellitus (DM), severe acute glycemic crises still occur. In this study, the characteristics of patients who were transported to an emergency department due to acute glycemic crises were investigated.We enrolled patients who were transported to our hospital by ambulance due to
hypoglycemia or
hyperglycemia during the period from January 2015 to December 2019. Initial
glucose levels below 70 mg/dL and above 250 mg/dL were defined as
hypoglycemia and
hyperglycemia, respectively.In the 5-year period, 16,910 patients were transported to our hospital by ambulance. Of those patients, 87 patients (0.51%) were diagnosed with
hypoglycemia, 26 patients (0.15%) were diagnosed with
hyperglycemia and 1 patient was diagnosed with
lactic acidosis. Compared to patients with
hypoglycemia, blood
urea nitrogen, serum
potassium and
hemoglobin levels were higher in patients with
hyperglycemia. Systolic blood pressure was lower and pulse rate was higher in patients with
hyperglycemia, possibly reflecting
dehydration in
hyperglycemia. Patients with
hyperglycemia were younger (63 vs 70 years old, median), more likely to be hospitalized (92.3% vs 23.0%) with poorer prognosis (23.1% vs 4.6%) than those with
hypoglycemia. In 64 DM patients with
hypoglycemia, 34 patients were treated with
insulin and 24 patients were treated with sulfonylurea or glinide, and their medication was often inappropriate. Excessive alcohol intake and
malnutrition were the main causes of
hypoglycemia in 23 non-DM patients. The main reasons for
hyperglycemia were interrupted treatment, forgetting
insulin injection and
infection.To avoid acute glycemic crises, optimization of anti-DM
therapy and education of patients are needed.