Diabetic mortalities in Ilesa, Nigeria: a retrospective study.

Twenty five patients (15 males and 10 females) died out of a total of 114 diabetics (21.9 pc) admitted over a six year period. Fourteen of them were new cases diagnosed for the first time on presentation. Death occurred within 72 hours of admission for eight (57 pc) of these new cases. Among the 11 known diabetics who died, eight were clinic defaulters. Diabetic ketoacidosis (DKA) was the cause of death in eight (32 pc) of the patients studied and this proved to be the commonest cause of death. Results of laboratory tests for five patients were not available before their death and two patients with DKA could not afford the over the counter cost of insulin and normal saline as they were unavailable in the hospital pharmacy at the time of their presentation. This study clearly demonstrates that the risk of death among Nigerian diabetics is increased by a high defaulting rate and delayed diagnosis and treatment. This is further aggravated by the near absence of emergency laboratory services and drug shortages in the hospital.