Clinico-Biochemical Profile and Hospital Based Outcome of Patients With Diabetic Ketoacidosis Admitted in a Tertiary Care Institute in Assam

Abstract

BACKGROUND Diabetes mellitus is a metabolic disorder which is characterized by chronic hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. Globally, the prevalence of diabetes among adults is estimated to be 537 million in 2021 and is expected to be 783 million by 2045. Most patients with DKA recover when treated appropriately but if remained untreated, may lead to complications and rise in mortality and morbidity. Hence, early identication of ketoacidosis and aggressive management with insulin, intra-venous uids and electrolytes replacement may change the outcome of the disease. A hospital based METHODOLOGY observational study recruited 60 patients of age more than 12 years admitted under the Department of Medicine, GMCH with Diabetic Ketoacidosis from 1stJuly 2020 to 31st June 2021. DKA was seen in all the age RESULTS groups but predominantly in middle-aged patients in 41-50 years age group (28%) with male predominance (Male:Female ratio =1.7:1). The incidenceof DKA was more among Type 2 Diabetes (76.7%) than with Type 1 Diabetes (23.3%) . Mortality of patients in the study was found to be 18.3%, which was higher in comparison to standard literature. Most of the patients in the study presented with nausea, vomiting and pain abdomen (28.30%). Sepsis and inadequate therapy (31.6% and 20.0%) were the leading precipitating cause of DKA Among the patients, 33.33% presented with severe DKA at the time of presentation and it was also observed that there is signicant correlation between severity of the disease and mortality (P <0.05). Patients with Poor GCS, raised serum creatinine, blood urea, serum calcium, alanine transaminase, aspartate transaminase and total serum bilirubin has signicant correlation with mortality (P value <0.05). However, the body mass index, blood sugar, pH, serum bicarbonate, sodium, potassium, magnesium, albumin, triglyceride, glycosylated haemoglobin, total leucocyte count and haemoglobin levels at the time of presentation do not have a signicant correlation with mortality (P value >0.05). It was observed from CONCLUSION our study that contrary to standard literature, the incidence of DKA is more common in adults than children. DKA was signicant in patients with type 2 diabetes in our series of patients and hence further studies are necessary to re-evaluatethis observation. CONFLICT OF INTEREST None