Abstract

Introduction: Diabetic ketoacidosis (DKA) is a complication of hyperglycemia. Through this study we plan to study the clinical features of DKA and precipitating factors responsible for DKA in type 1 and type 2 diabetes.Methods: This cross-sectional observational study was conducted in the emergency department of a tertiary care hospital in Sukkur, Pakistan from August 2019 to February 2020. Symptoms and precipitating factors were noted in a self-structured questionnaire.Results: Out of 71 patients, 19 (26.7%) patients had type 1 diabetes mellitus and 52 (73.3%) patients had type 2 diabetes mellitus. The most common clinical symptom was nausea and vomiting (57.7%), followed by pain in abdomen (42.2%) and dehydration (42.2%). We found that the most common precipitating factors were infections (69.0%) and non-compliance to treatment (53.5%). Among various infections, people commonly presented with pneumonia (38.7%) and urinary tract infection (30.6%).Conclusion: Diabetic ketoacidosis presents with vague symptoms such as nausea, vomiting, and pain in abdomen. Characteristic findings of DKA such as Kussmaul breathing was present in limited patients. Infections in diabetic patients should be carefully monitored as they are the most common precipitating factors for DKA.

Highlights

  • Diabetic ketoacidosis (DKA) is a complication of hyperglycemia

  • This study aims to assess the trend of clinical features of DKA and its precipitating factors in diabetic patients

  • Diagnostic criteria mentioned in the International Society for Paediatric and Adolescent Diabetes (ISPAD) Clinical Practice Consensus Guidelines 2018 were used as a reference for diagnosis and management of DKA [5]

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Summary

Introduction

Diabetic ketoacidosis (DKA) is a complication of hyperglycemia. Through this study we plan to study the clinical features of DKA and precipitating factors responsible for DKA in type 1 and type 2 diabetes. Diabetes can lead to a number of complications such as hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA) [1]. The clinical outcome of DKA depends upon the patient’s response to initial medical intervention, the precipitating factor for DKA, and biochemical values. Factors such as advanced age, bedridden state, and the use of mechanical ventilator are independent predictors associated with 30-day mortality [4]

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