DIABETIC KETOACIDOSIS;

EVALUATING OUTCOMES IN THE MANAGEMENT OF DIABETIC KETOACIDOSIS AMONG ESTABLISHED AND NEWLY DIAGNOSED TYPE 1 DIABETICS

Authors

  • Muhammad Imran Hassan Khan PGMI / AMC / LGH, Lahore.
  • Junaid Mushtaq PGMI / AMC / LGH, Lahore.
  • Ibtesaam Amjad PGMI / AMC / LGH, Lahore.
  • Israr ul Haque Toor PGMI / AMC / LGH, Lahore.
  • Ghias un Nabi Tayyab PGMI / AMC / LGH, Lahore.

DOI:

https://doi.org/10.29309/TPMJ/2018.25.08.86

Keywords:

Diabetes, Ketoacidosis, Precipitating Factors

Abstract

Objectives: 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. Study Design: Retrospective study. Setting: Lahore General
Hospital, Lahore. Period: From January 2013 through December 2015. Methods: Patients who
were admitted with a diagnosis of DKA. The clinical presentations, laboratory investigations,
management, time of recovery and outcome were compared. Data were collected via
retrospective chart review. 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.

Author Biographies

Muhammad Imran Hassan Khan, PGMI / AMC / LGH, Lahore.

MBBS, FCPS (Medicine), MRCP
(UK),
MRCPS (Glasg), FRCP (Edin),
FRCP (Glasg); FRCP (London);
Associate Professor
Department of Medicine

Junaid Mushtaq, PGMI / AMC / LGH, Lahore.

MBBS, FCPS Postgraduate
Resident, Medical-1

Ibtesaam Amjad, PGMI / AMC / LGH, Lahore.

MBBS, FCPS Postgraduate
Resident, Medical-1,

Israr ul Haque Toor, PGMI / AMC / LGH, Lahore.

MBBS, FCPS (Medicine),
Associate Professor,
Medical-1,

Ghias un Nabi Tayyab, PGMI / AMC / LGH, Lahore.

MBBS, FCPS (Medicine), MRCP
(UK),
Professor and Principal
Ameer ud Din Medical College,

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Published

2018-08-04