heroin and Diabetic-Ketoacidosis

Diabetic ketoacidosis (DKA) and poor glycaemic control in young adults with Type 1 diabetes may be associated with street drug use. There are few studies in the UK looking at the prevalence of drug use in young adults with diabetes.. One hundred and fifty-eight young adults, aged sixteen to thirty years, with Type 1 diabetes attending an urban diabetes clinic were sent an anonymous confidential postal questionnaire to determine the prevalence of street drug use.. We received 85 completed responses. Twenty-nine percent of respondents admitted to using street drugs. Of those, 68 percent habitually took street drugs more than once a month. Seventy-two percent of users were unaware of the adverse effects on diabetes.. Self-reported street drug usage in young adults with Type 1 diabetes is common and may contribute to poor glycaemic control and serious complications of diabetes.

Topics: Adolescent; Adult; Cannabis; Cocaine; Diabetes Mellitus, Type 1; Diabetic Ketoacidosis; Dopamine Uptake Inhibitors; Hallucinogens; Heroin; Humans; Illicit Drugs; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Prevalence; Substance-Related Disorders; Surveys and Questionnaires; United Kingdom

To determine the prevalence of self-reported, heroin-associated asthma symptoms among inner-city patients treated for life-threatening asthma, and to compare the rates of drug use between ICU patients with asthma and ICU control patients with diabetic ketoacidosis (DKA).. Study 1 was a sequential case series of patients requiring ICU admission for asthma (January to June 1999). Study 2 was a retrospective, case-control study of drug use among asthma patients and control subjects with DKA requiring ICU care (1997 to 1998).. Inner-city, public hospital ICU.. Twenty-three patients (26 ICU admissions) with asthma (age range, 16 to 50 years) admitted to the ICU from January to June 1999, and 84 patients (104 ICU admissions) with asthma and 42 patients with DKA (age range, 15 to 50 years) admitted to the ICU during 1997 to 1998. Outcomes studied: Self-reported, heroin-associated exacerbations, history of heroin or cocaine use, and urine drug screen (UDS) results.. In the sequential ICU admissions, 13 of 23 patients (56%) described asthma exacerbations associated with heroin insufflation. In the case-control study, asthmatics were significantly more likely to report heroin use (41.3% vs 12.5%; p = 0.006) and had a significantly higher prevalence of UDS results positive for opiates (60% vs 7%; p = 0.001) compared to subjects with DKA. The rates of cocaine use by history and UDS results did not differ significantly between the two groups.. At least since 1997, heroin insufflation is a common asthma trigger in this inner-city ICU and should be considered in the care of patients with life-threatening asthma.

Topics: Adolescent; Adult; Asthma; Case-Control Studies; Chicago; Cocaine-Related Disorders; Cross-Sectional Studies; Diabetic Ketoacidosis; Female; Heroin; Heroin Dependence; Humans; Intensive Care Units; Male; Middle Aged; Patient Admission; Retrospective Studies; Substance Abuse Detection; Urban Population

Topics: Adult; Brain; Diabetic Ketoacidosis; Diagnosis, Differential; Drug Overdose; Emergencies; Fatal Outcome; Heroin; Heroin Dependence; Humans; Male; Patient Transfer; Psychiatric Department, Hospital

Topics: Adolescent; Diabetes Complications; Diabetic Ketoacidosis; Heroin; Humans; Male; Substance Withdrawal Syndrome