Clinical profile and outcome of diabetic ketoacidosis in a tertiary care hospital in South India

Abstract

Background: There is little information on the clinical profile and outcome of children with diabetic ketoacidosis in India. We analysed the data of children managed by us at a tertiary care hospital in order to study the clinical profile of the children admitted with DKA. Methods: This descriptive retrospective study was conducted in pediatric ICU of tertiary level care hospital at Chitradurga, Karnataka (between June 2011 and May 2014). The case records of 52 children admitted with DKA were reviewed and information with respect to the personal details, clinical features, laboratory parameters, management and outcome was recorded using a predesigned proforma. The data was analyzed using SPSS VS-21. Results: The median age at presentation was 7.52 years (range: 2-14 years) with a male:female ratio of 1.3:1. 80.7% were newly diagnosed type 1 DM. 46(88 %) of the cases belonged to lower socio economic status.41 (78%) were from rural areas. The most common presenting complaints were polyuria and polydipsia in 42 cases (80.7%). Twenty eight children (53.8%) presented with severe DKA. The most common presenting complaints were polyuria and polydipsia (80.7%). The average length of stay in the ICU was 3.5 days. The mortality rate was 11.5% (6 cases). Cerebral edema was the commonest cause for fatality. The prevalence of DKA amongst all pediatric admissions was higher than that estimated in previous studies (1 in 419 cases). Conclusions: The outcome of active management of diabetic ketoacidosis in children is rewarding. Diabetic ketoacidosis is a life threatening complication of diabetes mellitus in children. Boys and girls were equally affected. Early identification and careful monitoring of fluids, electrolytes and renal function are the cornerstones of successful DKA management.