Time to hyperglycemic emergency and its predictors among adult diabetic patients on follow-up in four public hospitals, in central Ethiopia.

Diabetes mellitus is a common metabolic disorder resulting from either insulin deficiency or ineffectiveness. Hyperglycemic Emergency are the major serious acute complications of diabetes mellitus. Even though; there is an increasing impact of hyperglycemic emergency among adult diabetic patients, its incidence and predictors have not been well studied particularly in Ethiopia. Hence, this study aimed to assess the time to hyperglycemic emergency and its predictors among adult diabetic patients in the follow-up treatment of public hospitals in Hadiya Zone, Central Ethiopia. An institutional-based retrospective follow-up study was conducted from September 1/2019 to August 30/2022. A total of 455 samples were selected using a systematic random sampling technique. Data was collected using a prepared checklist extraction from patients' charts. The data were entered into epi-data version 4.6 software and then exported to STATA version 14.0 for analysis. Kaplan- Marie survival function and Log-rank test were computed. The assumption was checked by using the Schoenfeld residual test. All variables in bivariate analysis, p-value < 0.20 were entered into a multivariate Cox regression model. Adjusted hazard ratio with 95% Confidence interval was reported to declare the strength of association between independent variables and outcome variable and statistically significant at p-value < 0.05. Model fitness was checked by using the Cox-Snell residual. Finally, data was presented in text, table and graph. The proportion of hyperglycemic emergency among diabetes patients was 56%, with a median time to develop hyperglycemic emergency is 14.3 months. The incidence rate of hyperglycemic emergency among diabetes mellitus patients was 44.1 (95% CI: 39.0, 49.8) per 1000 person month of observation. The study also found that diabetic patients with age of under 40(AHR = 2.1; 95% CI: 1.44, 3.09), had no health insurance AHR = 1.5; 95%CI: 1.11, 1.89), had comorbidities (AHR = 1.6; 95% CI: 1.22, 2.06), missed medication histories before the occurrence of HGEs (AHR = 1.8; 95% CI: 1.41, 2.40), and had poor glycemic control (AHR = 1.5; 95% CI: 1.09, 1.99) were significant predictors of hyperglycemic emergency. The study found that hyperglycemic emergency was a major public health among the diabetic population. The study also found significant predictors for developing hyperglycemic Emergency among diabetic patients including those under 40 years of age, comorbidity, having no health insurance, missing prescribed medication, and poor glycemic control. This study recommends that healthcare providers, policymakers, and community organizations work together to reduce the incidence of hyperglycemic Emergency among diabetic patients, ultimately improving health outcomes and quality of life for this vulnerable population.