Abstract

Diabetic ketoacidosis (DKA) is one of the most common medical emergencies in the world. The patient can present with manifestations like ketosis, ketoacidosis, ketoacidosis precoma and coma, but often these manifestations are submerged in the clinical presentation of precipitating illnesses. Objective: To assess the clinical profile and biochemical characteristics in diabetic ketoacidotic patients and to assess the precipitating factors triggering diabetic ketoacidosis. Methods: This cross sectional study conducted in Mandya Institute of Medical Sciences, Mandya was done from January 2019 to December 2019 involving 50 patients who presented with Diabetes Ketoacidosis. Method of data collection was done by history taking, clinical examination, laboratory and radiological investigations. SPSS V22 was used for statistical analysis. P <0.05 was considered as statistically significant. Results: Out of 50 patients admitted for diabetic ketoacidosis; 30 were type 2 diabetes (60%) and 20 (40%) were type 1 diabetes mellitus. Average age at the time of presentation was 45 + 18.45 years. The most common clinical features at the time of presentation were vomiting (72%), abdominal pain (42%), acidotic breathing (84%) and dehydration (88%). The commonest precipitating factor was infection (50%) followed by irregular treatment (26%) and other factors (26%). The mean values for RBS, HCO3 and pH was 432.9 + 88, 13 + 3.57 and 7.18 + 0.96 respectively. Mortality rate was 8% and factors found to be predict the high mortality were high RBS, low pH, low HCO3, altered sensorium at the time of presentation and comorbid conditions. Conclusion: Most common precipitating factors are infection and irregular treatment. Most common clinical features at the time of presentation are vomiting, abdominal pain, dehydration, acidotic breathing. There is no significant difference in the clinical and biochemical profile of patients with type 1 and type 2 diabetes. Mortality rate in diabetic ketoacidosis is 8% and the predictors of poor prognosis are; high RBS, low pH, low HCO3, altered sensorium at the time of presentation and comorbid conditions.

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