Biochemical profile of diabetic ketoacidosis in type 2 diabetes patients: an observational study
DOI:
https://doi.org/10.18203/2349-3933.ijam20240359Keywords:
Diabetes ketoacidosis, Type 2 diabetes, Biochemical profileAbstract
Background: The present study was conducted to assess the clinical profile of type 2 diabetes patients presenting with diabetic ketoacidosis and review their biochemical parameters at the time of presentation.
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. All the participants were subjected to detailed clinical examination and biochemical analysis during hospitalization and parameters were monitored.
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. One patient died and 59 survived (mortality rate-1.6%). Comparatively higher mean RBS, higher mean serum osmolality and lower pH were observed in the death case in comparison with those who survived. The patient who died had no statistically significant difference in serum sodium, potassium, calcium and magnesium but had lower serum HCO3- than alive patients on admission.
Conclusions: DKA is a serious metabolic complication even in cases of type 2 diabetes and higher RBS, higher Sr Osmolality and lower pH at the time of presentation correlate directly with poorer outcomes.
References
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.
Kitabchi AE, Umpierrez GE, Fisher JN, Murphy MB, Stentz FB. Thirty years of personal experience in hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state. J Clin Endocrinol Metab. 2008;93(5):1541-52.
Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism. 2016;65(4):507-21.
Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diab 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 Internal 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. Hyperglycemic crises in adult patients with diabetes: a consensus statement from the American Diabetes Association. Diab Care. 2009;32(7):1335-43.
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.
Adhikari PM, Mohammed N, Pereira P. Changing profile of diabetic ketosis. Journal of the Indian Medical Association. 1997;95(10):540-2.
Welch BJ, Zib I. Case study: diabetic ketoacidosis in type 2 diabetes: look under the sheets. Clin Diab. 2004;22(4):198-201.
Matoo VK, Nalini K, Dash RJ. Clinical profile and treatment outcome of diabetic ketoacidosis. J Assoc Physic India. 1991;39(5):379-81.
Narasimham YV, Krishna Murthy A, Satyanarayana Y. Clinical and investigational study of diabetic ketoacidosis. J Evid Based Med Healthcare. 2015; 2(25):3726-4.
Sobngwi E, Mauvais-Jarvis F, Vexiau P. Diabetes in Africans. Part 2: Ketosis-prone atypical diabetes mellitus. Diab Metab. 2002;28:5-12.
Efstathiou SP, Tsiakou AG, Tsioulos DI, Zacharos ID, Mitromaras AG, Mastorantonakis SE, et al. A mortality prediction model in diabetic ketoacidosis. Clin Endocrinol. 2002;57(5):595-601.
Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality United States, 2000–2014. Morbid Mortal Week Rep. 2018;67(12):362.
Faich GA, Fishbein HA, Ellis SE. The epidemiology of diabetic acidosis: a population-based study. Am J Epidemiol. 1983;117(5):551-8.
Ellemann K, Soerensen JN, Pedersen L, Edsberg B, Andersen OO. Epidemiology and treatment of diabetic ketoacidosis in a community population. Diab Care. 1984;7(6):528-32.