A Prospective Study of Risk Factors, Clinical Profile and Outcome in Patients of Diabetic Ketoacidosis (DKA) in Type II Diabetes Patients
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction: Diabetic ketoacidosis (DKA), a well-known and major acute metabolic complication, classically occurs in young patients with type 1 diabetesmellitus (T1DM). However, it may also occur in patients with type 2 Diabetes Mellitus (T2DM). Hence, this study was planned to assess and find out the association between clinical profile, laboratory profile and clinical outcome of DKA patients in T2DM. Study aimed to assess the clinical profile and outcome of DKA in patients of T2DM. Material and Methods: Hundred T2DM patients, admitted with DKA were studied at Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal. Data on demography (age, sex, diabetes duration), co-morbidities, precipitating factors, presenting complaints, body mass index (BMI), hemoglobin (Hb), random blood sugar (RBS), glycated hemoglobin (HbA1c) and arterial pH were recorded for each patients. Nature of treatment and outcome was also recorded. Results: Most of the our patients with DKA had age between 51-55 years (21%), were male (72%) and were obese (46%). Most of them were on oral hypoglycemic drugs (70%). Mean duration of diabetes, BMI, Hb, RBS, HbA1c and pH was 7.28±3.81 years, 29.00±3.58 kg/m2, 9.8±1.42 gm%, 351.72±22.32 mg/dl, 9.3±1.23%, 7.14±0.10 respectively. Out of 100 patients, 86% were discharged, 7% succumbed to death while 7% left the study. Most common co-morbidity, clinical symptoms and precipitating factor in DKA patients were hypertension (60%), obesity (47%), nausea vomiting (86%), abdominal pain (58%), poor compliance (53%) and infection mainly pneumonia (24%). Patients who died, majority of them were having diabetes duration >10 years (23.1%) (p=0.012), poor compliance (10.2%) (0.028), had CVD (40%) (p=0.004) and ACS (40%) (p=0.004). Conclusion: DKA is a fatal acute metabolic complication even in T2DM with heterogeneous clinical presentation. Early diagnosis and treatment can avoid morbidity and mortality.
Authors and Affiliations
Srishti Sonwani, Anita Arya, Rita Singh Saxena
Keywords
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