A STUDY OF CLINICAL AND BIOCHEMICAL PROFILE OF PATIENTS OF DIABETIC KETOACIDOSIS

Dr. Praharsh Pathak, Dr. Abhishek Mistry, Dr. Abhijit Basu

Abstract


Objectives: To study the clinical and biochemical profile of patients of diabetic ketoacidosis admitted. To compare various parameters of clinical and biochemical profile before and after treatment.

Methods: 30 adult patients with diabetic ketoacidosis admitted in medicine department of Geetanjali medical college and hospital, meeting the inclusion criteria, over a period of 1 years (Jan 2018 to Dec 2018). Patients fulfilling diagnostic criteria of DKA and inclusion criteria were enrolled. Diagnostic criteria are plasma glucose >250 mg/dl, blood pH <7.30, serum bicarbonate <15 mEq/l, urine ketones positive.

Results: 24 patients had type 2 diabetes (80%) and 6 (20%) patients had type 1 diabetes. Average age at the time of presentation was 44.20 ± 13.17 years. The commonest precipitating factor was infection (83.33%) followed by irregular or no treatment (40%) and other factors (16.67%). The most common clinical features at the time of presentation were breathlessness, vomiting, fever, abdominal pain, dehydration and acidotic breathing. The mean values for RBS, pH, HCO3 were 449.45 ±   71.45, 7.19 ± 0.10, and 10.42 ± 3.48 respectively at the time of presentation. There was no significant difference in clinical and biochemical profile of patients with type 1 and type 2 diabetes. Mortality rate was 3.33%.

Conclusion: Most common clinical features at the time of presentation are breathlessness, vomiting, fever, abdominal pain, dehydration and acidotic breathing. There is no significant difference in the clinical and biochemical profile of patients with type 1 and type 2 diabetes. Mortality rate in diabetic ketoacidosis is 3.33% and the most notable predictors of poor prognosis are; severity of altered sensorium, severity of comorbid condition, severe dehydration, severe acidosis.

Keywords


Diabetic ketoacidosis; mortality; predictors; Precipitating factors.

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References


Samreen Riaz: Diabetes mellitus. Scientific Research and Essay Vol. 4 (5) pp. 367-373, May, 2009.

Powers AC. Diabetes Mellitus. In: Longo DL, Kasper DL, Jamson JL, Fauci AS, Hauser SL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18th Edition, United States: McGraw-Hill; 2012.

Umpierrez GE, Kitabchi AE. Treat Endocrinol. Diabetic ketoacidosis: risk factors and management serategies. 2003;2(2):95-108.

Akhtar J, Jabbar A, Islam N, Khan MA. Prevalence and clinical profile in diabetic ketoacidosis. J Pak Med Assoc 1993 Jul; 43(7):137-9.

V. Seshiah. Acute complications of diabetes mellitus. In: Shah SN, editor. API Text Book of Medicine. 7th Edition, India: API; 2003.

Matoo VK, Nalini K, Dash RJ, et al. Diabetic ketoacidosis – A clinical study. JAPI 1991 May; 39(5):379-81.

Rajsoorya C, Wong SF, Chew LS. Clinical and biochemical profile in diabetic ketoacidosis. Singapore Med J 1993 Oct; 34(5):381-4.

D Rao V, B Pradhan, Y Mallikarjuna, R Reddy. Clinical profile of diabetic ketoacidosis in adults. Health Renaissance 2012; Vol 10 (No.2); 80-86

Stamatis P, Efstathiou, Aphrodite G, Tsioulos, Loannis et al. A mortality

prediction model in diabetic ketoacidosis. Clin Endocrinol 2002; 57:595-

Newton CA, Raskin P. Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes Mellitus: Clinical and Biochemical Differences. Arch Intern Med. 2004;164(17):1925-1931. doi:10.1001/archinte.164.17.1925.

Pinnies JA, Cairo G, Gaztambide S, Vazquez JA. Course and prognosis

of 132 patients with diabetic ketotic and non-ketotic hyperosmolar state.

Diabetes Metab 1994 Jan-Feb; 20(1):43-8


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