A bstract Background: Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication of diabetes mellitus, characterized by hyperglycemia, ketonemia, and high-anion-gap metabolic acidosis. The incidence, clinical presentation, and outcomes of DKA vary according to age, type and duration of diabetes, precipitating factors, and access to healthcare. Objectives: This study aimed to evaluate the clinico-biochemical profile, precipitating factors, insulin requirements, and clinical outcomes, including intensive care unit (ICU) stay duration, time to resolution of DKA, and mortality, among patients admitted with DKA. Methodology: This prospective observational study enrolled 50 consecutive DKA patients, admitted to the medical ICU, from January 2020 to November 2021. Detailed clinical data and laboratory parameters were systematically recorded and analyzed. Results: The mean age was 35.0 ± 16.0 years with female predominance (54%); 62% had type 1 diabetes mellitus, and 38% type 2 diabetes mellitus (T2DM). DKA occurred early, with 48% presenting within 1–5 years of diagnosis. Infection (50%) and treatment nonadherence (32%) were the main triggers. The predominant symptoms were nausea/vomiting (68%), abdominal pain (48%), fever (46%), and dyspnea (44%). The mean glucose was 448.9 ± 114.0 mg/dL, pH 7.05 ± 0.15, and bicarbonate 8.8 ± 5.1 mEq/L. Severe DKA occurred in 56%, and mortality was 10%. Nonsurvivors were older, had T2DM, with higher glycated hemoglobin, urea, and more frequent acute kidney injury. Conclusion: DKA mainly affects young patients early in the disease, but remains a significant cause of mortality in older T2DM patients. Infection and poor treatment adherence are the main triggers. Early diagnosis, prompt management, and patient education are key to better outcomes.
Ashraf et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: