A Retrospective Study to Evaluate Precipitating Factors, Outcome and Importance of Health Education in Diabetic Ketoacidosis

Abstract

Aim: To observe the frequency, precipitating factors and outcome of diabetic ketoacidosis (DKA) in adults with established and newly diagnosed type 1 diabetes at a tertiary care hospital. Methods: Patients who were admitted with a diagnosis of DKA at Lahore General Hospital, Lahore from January 2013 through December 2015. The clinical presentations, laboratory investigations, management, time of recovery and outcome were compared. Results: A total of 202 patients were included who fulfilled the criteria of DKA, of which 160(79.2%) were less than 26 years of age with a male predominance of 156(97.5%). Out of all cases 72(35.6%) had established Type 1 diabetes and 130(64.4%) were newly diagnosed. The most common presenting complaints in both groups were sepsis 105(52%). The comparison of clinical improvement and laboratory investigations between the two groups showed that newly diagnosed Type 1 diabetes patients had lower pH, low bicarbonate and high BSR at presentation as compared to those with established type 1 diabetes. The patients with established diabetes improved earlier, required lesser duration of intravenous fluids and IV insulin was changed to subcutaneous in less time. Hospital stay of more than 7 days was observed in patients with new diagnosis. Conclusion: It can be concluded from the above data that earlier diagnosis of type 1 diabetes mellitus, appropriate treatment, regular screening for complications and infections will result in less hospital admissions and better outcome.