Frequency and Precipitating Factors of Hyperglycemic and Hypoglycemic Emergencies in Diabetic Patients Presenting at Tertiary Care Hospital, Islamabad

Diabetes mellitus (DM) is a highly widespread chronic metabolic condition and one of the major challenges to the health care system because of its acute and chronic complications. Objective: To determine the frequency and precipitating factors of hyperglycemic and hypoglycemic emergencies among diabetic patients presenting to a tertiary care hospital in Islamabad. Methods: A cross-sectional study at the Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, between 5th April 2025 and 5th October, 2025. The enrolled sample size was 150 diabetic patients with altered consciousness (GCS ≤13) between the ages of 30 and 80 years using non-probability consecutive sampling. A structured pre-tested proforma was used to gather socio-demographic and clinical information such as type and duration of diabetes, modality of treatment, comorbidity, and past glycemic emergency. The Chi-square test, t-test, and the Mann–Whitney U test was applied, and a p-value of less than 0.005 was considered statistically significant. Results: Hyperglycemic emergencies were found to be 64.0%, and hypoglycemic emergencies were found to be 36.0%. The predictors of hyperglycemia that had significant values were missed insulin/medication (AOR = 4.21, p<0.001), infection (AOR = 3.67, p=0.001), and poor dietary adherence (AOR = 1.92, p=0.045). Hypoglycemia was independently predicted by excess levels of insulin/OHA (AOR = 5.62, p<0.001). Conclusion: Hyper and hypoglycemic crises are frequently observed in diabetic patients, and they are mostly caused by modifiable factors, including missed medications, infections, noncompliance with diets, overdosing, and missed meals. By focusing on these particular factors, it is possible to minimize morbidity and enhance the outcome.