Clinical profile of diabetic ketoacidosis in type 2 diabetes patients at a tertiary care centre

Hardik More; Dilip Patil; Chahat Singh

doi:10.18203/2320-6012.ijrms20233996

Authors

Hardik More Department of Cardiology, Government Medical College and Superspecialty Hospital, Nagpur, Maharashtra, India
Dilip Patil Department of Medicine, ACPM Medical College, Dhule, Maharashtra, India
Chahat Singh ACPM Medical College, Dhule, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233996

Keywords:

Diabetes ketoacidosis, Type 2 diabetes, Clinical profile

Abstract

Background: The present study was undertaken to analyse the clinical profile of type 2 diabetes patients presenting with diabetic ketoacidosis at the time of presentation, owing to dearth of scientific enquiry into this research query.

Methods: The present study was an analytical, cross-sectional study conducted over the period of two years. All the type 2 diabetes patients with diabetic ketoacidosis admitted during the study period constituted the study population, after being subjected to prefixed selection criteria. Detailed clinical history was recorded and thorough physical examination was conducted of all the participants, along with basic relevant blood parameters.

Results: Out of the total 60 type 2 DM patients with DKA studied, 53.3% patients belonged to 51 to 60 years age group and 55% were males. All the patients had fruity breath odour at the presentation. Obesity was present in 48.3% and Kussmaul breathing observed in 90% of patients. Poor compliance to treatment (51.7%) was the biggest precipitating factor of DKA in type 2 DM patients. Around 2/3^rd (68.3%) was on oral hypoglycemic agents (OHA), 10% were on OHA and insulin, while 21.7% were newly diagnosed at the time of presentation. Mean RBS in type 2 DM patients with DKA was 510.8±153.5 mg/dl and mean HbA1C was 9.15±0.78%.

Conclusions: Stricter compliance to the treatment will go a long way in avoiding occurrence of the dreaded complication in type 2 diabetes patients.

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References

Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335.

Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism. 2016;65(4):507-21.

World Health Organization. Global Health Estimates: Life expectancy and healthy life expectancy. Available at: https://www.who. int/data/gho/data/themes/mortality-and-global-health-estimates/ghe-life-expectancy-and-healthy-life-expectancy. Accessed on 15 October 2023.

Huizinga MM, Rothman RL. Addressing the diabetes pandemic: A comprehensive approach. Indian J Med Res. 2006;124(5):481-4.

Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125:217-30.

Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(1):s5-20.

Newton CA, Raskin P. Diabetic ketoacidosis in type 1 and type 2 diabetes mellitus: clinical and biochemical differences. Arch Int Med. 2004;164(17):1925-31.

Barski L, Nevzorov R, Jotkowitz A, Rabaev E, Zektser M, Zeller L, et al. Comparison of diabetic ketoacidosis in patients with type-1 and type-2 diabetes mellitus. Am J Med Sci. 2013;345(4):326-30.

Kitabchi AE, Umpierrez GE, Miles JM, et al. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2009;32(7):1335-43.

Faich GA, Fishbein HA, Ellis SE. The epidemiology of diabetic acidosis: a population-based study. Am J Epidemiol. 1983;117(5):551-8.

Kreisberg RA. Diabetic ketoacidosis. Diabetes mellitus: theory and practice. New York: Elsevier Science. 1990;591-603.

Sonwani S, Arya A, Saxena RS. A prospective study of risk factors, clinical profile and outcome in patients of diabetic ketoacidosis (DKA) in type II diabetes patients. Int J Contemp Med Res. 2018;5(4):21-4.

Seth P, Kaur H, Kaur M. Clinical profile of diabetic ketoacidosis: a prospective study in a tertiary care hospital. J Clin Diagnost Res. 2015;9(6):OC01.

Narasimham YV, Krishna Murthy A, Satyanarayana Y. Clinical and investigational study of diabetic ketoacidosis. J Evid Based Med Healthc. 2015;2(25):3726-4.

Sobngwi E, Mauvais-Jarvis F, Vexiau P, Mbanya JC, Gautier JF. Diabetes in Africans. Part 2: Ketosis-prone atypical diabetes mellitus. Diabetes Metab. 2002;28(1):5-12.

Adhikari PM, Mohammed N, Pereira P. Changing profile of diabetic ketosis. J Indian Med Assoc. 1997;95(10):540-2.

Welch BJ, Zib I. Case study: diabetic ketoacidosis in type 2 diabetes:" look under the sheets". Clin Diabetes. 2004;22(4):198-201.

Matoo VK, Nalini K, Dash RJ. Clinical profile and treatment outcome of diabetic ketoacidosis. J Assoc Phys India. 1991;39(5):379-81.

Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality—United States, 2000–2014. Morb Mortal Wkly Rep. 2018;67(12):362.