Clinical Presentation and Biochemical Abnormalities in Patients Presented with Diabetic Ketoacidosis in BIRDEM Hospital

  • Suraiya Nazneen Registrar, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Fatema Ahmed Assistant Professor, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • SM Ashrafuzzaman Professor, Dept. of Endocrinology, BIRDEM General Hospital, Dhaka
  • Khwaja Nazim Uddin Professor of Medicine, BIRDEM General Hospital, Dhaka
  • ASM Areef Ahsan Professor and Head, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Mohammad Omar Faruq Professor, Dept. of Critical Care Medicine, Ibn Sina Hospital, Dhanmondi , Dhaka
  • Kaniz Fatema Assistant Professor, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Debasish Kumar Saha Registrar, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Madhurima Saha Registrar, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka
  • Kamrul Hasan Sohel Consultant, Bangladesh Eye Hospital, Dhaka
Keywords: Diabetic ketoacidosis, clinical presentation, precipitating cause, biochemical abnormalities

Abstract

Objective: To see the clinical presentation and biochemical abnormalities in hospitalized patients of Diabetic ketoacidosis.

Methodology: This cross sectional observational study was carried enrolling 55 subjects with Diabetic ketoacidosis, in the Department of Medicine, BIRDEM General Hospital, Dhaka, over a period of six months starting from April 2013 to September 2013.

Results: The mean age was 48.35±16.76 with age range from 30 to 68 years. Infection (pneumonia, urinary tract infection, cellulitis) 22(40%), omission of insulin or drugs 14 (25.4%), myocardial infarction 5(9.0%), and reduction of insulin dose 3(5.4%) worked as precipitating cause.Most patients had drowsiness 16(29.0%), moderate dehydration 30(55.5%), signs of infection 22(40%). About 13(23.56%) had Kussmauls type of respiratory pattern. Other signs were less obvious. Majority of the subjects 40(72.7%) had 3+ ketonuria at the time of admission in hospital. About 32(58.1%) of the known diabetic patients were on insulin from the beginning of their diagnosis.19 (34.4%) were initially on OHA followed by insulin and 14 (25.4%) patients took OHA alone.7 patients were on dietary modification and exercise without any drugs. Majority 52 (96.46%) patients had blood sugar level between 21-34 mmol/l and mean HbA1c was 12.31(SD±2.50).About 4(7.2%) patients had severe hyponatraemia and 22(40%) patients had hypokalaemia. Eight (14.5%) patients had severe acidosis while 18(32.7%) patients had only mild acidosis. Most of the subjects 29(52.7%) had moderate acidosis. Complete cure from DKA was observed in 53(96.3%) subjects. Only 2(3.6%) subjects developed cerebral oedema. It took 4 to 5 days in mild group, 6 to 8 days in moderate DKA and more than 9 days in severe DKA for recovery.

Conclusion: From the study result it could be concluded that infection control and regular administration of insulin or control of diabetes and proper Diabetes Self Management Education (DSME) can prevent diabetic ketoacidosis.

Bangladesh Crit Care J March 2017; 5(1): 7-10

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Author Biography

Suraiya Nazneen, Registrar, Dept. of Critical Care Medicine, BIRDEM General Hospital, Dhaka


Published
2017-05-11
How to Cite
Nazneen, S., Ahmed, F., Ashrafuzzaman, S., Uddin, K., Ahsan, A., Faruq, M. O., Fatema, K., Saha, D., Saha, M., & Sohel, K. (2017). Clinical Presentation and Biochemical Abnormalities in Patients Presented with Diabetic Ketoacidosis in BIRDEM Hospital. Bangladesh Critical Care Journal, 5(1), 7-10. https://doi.org/10.3329/bccj.v5i1.32535
Section
Original Articles