Diabetic ketoacidosis in prisoners without access to insulin. JAMA 1993 Feb 03;269(5):619-21
Date
02/03/1993Pubmed ID
8421367DOI
10.1001/jama.1993.03500050097033Scopus ID
2-s2.0-0027391627 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
OBJECTIVE: To assess the cause and clinical severity of diabetic ketoacidosis in male prisoners hospitalized in New York City.
DESIGN: Retrospective chart review.
SETTING: A municipal hospital in New York City.
PATIENTS: Forty-nine adult male prisoners with a total of 54 hospital admissions for diabetic ketoacidosis between January 1, 1989, and June 30, 1991.
MAIN OUTCOME MEASURES: Charts were reviewed for diabetic and medical history, time from arrest until hospitalization, cause of diabetic ketoacidosis, admission laboratory data, and hospital course.
RESULTS: Thirty-eight (70%) of the 54 admissions for diabetic ketoacidosis among prisoners occurred because prisoners had not received insulin during the period immediately following arrest (mean number of days from arrest until hospitalization was 2.5). All of these individuals had a history of insulin-dependent diabetes and were reportedly compliant with their insulin regimen at the time of arrest. Admission laboratory data for this group of prisoners included a mean serum glucose level of 27.4 mmol/L (495 mg/dL) and a mean serum bicarbonate level of 14.4 mmol/L. Mean number of days in the hospital was 3.4 including a mean of 1 day in an intensive care unit.
CONCLUSIONS: Inadequate access to medication results in serious sequelae for recently arrested prisoners in New York City with insulin-dependent diabetes. Access to health care for recently arrested prisoners needs to be improved.
Author List
Keller AS, Link RN, Bickell NA, Charap MH, Kalet AL, Schwartz MDAuthor
Adina L. Kalet MD Institute Director, Professor in the Kern Institute for Transforming Medical Education department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCausality
Diabetic Ketoacidosis
Health Services Accessibility
Hospitalization
Humans
Insulin
Law Enforcement
Male
New York City
Prisoners
Retrospective Studies
Severity of Illness Index
Withholding Treatment
