Diabetic ketoacidosis: principles of management

Sharma, Vandhna R.; Hadebe, Nkanyiso

doi:10.12968/hmed.2007.68.4.184

Cited by 9 publications

(6 citation statements)

References 31 publications

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“…Free fatty acids lead to into ketonemia and ketonuria by beta oxidation. 12 In our study mean age of the patients with DM-II was 50.09 ± 9.39 years, comparable mean age of the patients with DM-II was reported by Sheikh et al 8 Mean age of the patients with DM-II reported by Pinto et al 13 in their study was 45±12 which is also in agreement with our study. In present study male patients was 42% and female patients were 58% which is comparable with a study by Sheikh et al, 8 in his study male patients were 38.6% and female patients were 61.4%.…”

Section: Discussionsupporting

confidence: 92%

Type Ii Diabetics; Frequency of Diabetic Ketoacidosis

Farogh¹,

Mahmood²,

Ahmad³

2016

TPMJ

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Material and method: Permission was taken from Institutional review board and written informed consent was taken from every patient. Total 189 patients with type II DM (Un-controlled) having Fasting plasma glucose level ≥126mg/dl either male or female having age 35 years to 65 years were included in the study. Results: Total 189 patients with type II diabetes mellitus were included in this study. Mean age of the 50.09 ± 9.39 years. Male patients were 79 (42%) and female patients were 110 (58%). Insignificant association between gander and Ketoacidosis was seen. No association of family history of diabetes mellitus with Ketoacidosis was found. Conclusion: Results of this study showed that male or female can be equally victim of diabetic ketoacidosis. Diabetic ketoacidosis can be develop equally in younger or older age group. No significant difference for the development of diabetic ketoacidosis was found between obese/non-obese and patients with family history of diabetes or without family history of diabetes.

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Section: Discussionsupporting

confidence: 92%

Type Ii Diabetics; Frequency of Diabetic Ketoacidosis

Farogh¹,

Mahmood²,

Ahmad³

2016

TPMJ

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“…Mortality was 14% in UK, 4% in Denmark, 11.8% in Korea and 29.8% in Kenya. 21,22,10,12 . With better understanding of the pathophysiology of DKA and improvements in treatment, outcome is improving 23,24 .…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcome of Diabetic Ketoacidosis: Experience at BIRDEM, Dhaka, Bangladesh

Rahim

Rouf

Ahmed

et al. 2015

Bangladesh Crit Care J

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Background: Diabetic ketoacidosis (DKA) is a medical emergency. It may be the presenting feature of diabetes mellitus, but more commonly DKA complicates diabetic patients during inter-current acute illness or if they become non-compliant to anti-diabetic medications. Early detection and treatment of DKA including underlying cause is important in determining outcome.Objectives: To describe the demographic characteristics, presentations, precipitating factors and outcome of DKA.Methods: This cross-sectional study was conducted at BIRDEM General Hospital from January 2008 to December 2011.Results: Total patients were 200 with female predominance (56%). Mean age of the study population was 37.6 years. Incidence of DKA was more in known diabetic patients (71%) than in new cases (29%), more among rural population (53%) and low income group (76.5%). Common presentations included nausea (63%), vomiting (61%), polyuria (43%), polydypsia (42.5%), fever (29%), abdominal pain (28%), shortness of breath (28%), drowsiness (20%), blurred vision (13%), leg cramps (6.5%) and coma (7%). Infection (45.5%) was the commonest precipitating cause of DKA followed by non-adherence to insulin therapy (31%). Acute pancreatitis (5%), myocardial infarction (2%), stroke (1%) and surgery (1.5%) were less common precipitating factors. Aetiology of DKA could not be identified in 14% cases. Mean random blood glucose during admission was 27.1mmol/L and mean HbA1c was 11.3%. Severe acidosis (pH<7) was less common (8.5%). Neutrophil leukocytosis was present in 87% cases, irrespective of infection. In-hospital mortality was 6.5%.Conclusion: DKA occurred in diabetic patients in over two-third of the cases. In over two-third of the study population, DKA was precipitated by infection and non-adherence to insulin treatment. So, patient education regarding treatment compliance and sick days management are important and may prevent many cases of DKABangladesh Crit Care J September 2015; 3 (2): 53-56

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“…All other patients recovered. In the UK 17 , in-hospital mortality rate was upto 14% because of variations in management and various other factors, in Denmark 16 it was 4% and in Korea 14 , in-hospital mortality was 11.8%. In Nairobi 13 29.8% patients expired in hospital within 48 hours of admission.…”

Section: Discussionmentioning

confidence: 99%

Clinical Spectrum and Management of Diabetic Ketoacidosis: Experience in A Tertiary Care Hospital

Zaman³

et al. 2012

Birdem Med J

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Background: Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes mellitus (DM). It may be the presenting feature in type 1 DM, but more commonly it complicates previously diagnosed diabetic patients, both type 1 and type 2. If not recognized early and treated in a judicious way the outcome is often fatal. Objectives: The objectives of this study was to see the common presenting features of DKA, their precipitating causes, patterns of electrolyte imbalance, treatment requirement in early hours and to see the outcome. Materials and methods: This cross sectional study was done in BIRDEM General Hospital on fifty adult patients who presented with DKA over a period of nine months (January 2007 to September 2007). Results: Total number of patients were 50, male were 24 and female were 26 (M:F =12:13). Mean age was 27.6 ± 3.7 years. The incidence of DKA was more in known diabetic patients (32, 64%), in comparison with new cases (18, 36%). Frequency was more in poor village people (31, 62%). Vomiting (24, 48%) was the most frequent complaint, followed by fever (19, 38%), nausea (16, 32%), abdominal pain (14, 28%), weakness (13, 26%), polyuria (12, 24%) and polydypsia ( 8, 16%). Infection (18, 36%) was the most common precipitating cause, closely followed by inadherence to insulin therapy (17, 34%). In 12 (24%) cases no cause could be identified. Glycaemic control was poor, HbA1c was >7% in 98% cases. Severe acidosis (pH < 7) was less common (4, 8%) and gross electrolyte imbalance was uncommon but all patients required potassium supplementation in course of treatment. Neutrophilic leukocytosis was present in 44 (88%) cases, irrespective of presence of infection. Mortality was low (3, 6%). Conclusion: Diagnosis and treatment of DKA is not difficult if recognized early. So, high index of suspicion is necessary, particularly in previously undiagnosed cases. DOI: http://dx.doi.org/10.3329/birdem.v1i1.12380 Birdem Med J 2011; 1(1): 15-20

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Diabetic ketoacidosis: principles of management

Abstract: Diabetic ketoacidosis has a mortality of up to 14% in the UK, which could be attributed to varied treatment policies and a lack of a general consensus statement on its management. This article provides comprehensive guidelines for management of adult patients in diabetic ketoacidosis.

Cited by 9 publications

References 31 publications

Type Ii Diabetics; Frequency of Diabetic Ketoacidosis

Type Ii Diabetics; Frequency of Diabetic Ketoacidosis

Clinical Characteristics and Outcome of Diabetic Ketoacidosis: Experience at BIRDEM, Dhaka, Bangladesh

Clinical Spectrum and Management of Diabetic Ketoacidosis: Experience in A Tertiary Care Hospital

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