مقارنة الحماض الخلوني السكري بين مرضى الداء السكري من النمط 1 و النمط 2 و انتشار الداء السكري نمط 2 الميال لحدوث الحماض الخلوني

الملخص EN

Objective : To identify the different clinical and biochemical features of DKA between adult patients with type 1 and type 2 diabetes, and to identify the prevalence of ketosis prone type 2 diabetes mellitus (ketosis-prone T2DM).

Methods : All patients with diabetic ketoacidosis (DKA) were included in this study.

One hundred and twenty seven patients (11 to 76 years old) were prospectively enrolled in this cross-sectional study.

Clinical and biochemical characteristics of DKA were studied.

Patients were classified as having type 1 or type 2 diabetes based on treatment history and/or autoantibody status.

Groups were compared for differences in symptoms, biochemical profiles at presentation, and response to therapy.

Cases without precipitating cause were identified and the prevalence of ketosis prone type 2 diabetes mellitus (ketosis-prone T2DM) was calculated.

Results : Fifty one patients (40 %) presented with DKA had type 2 diabetes.The age of patients was higher in patients with T2DM (56 ± 11.9 years) compared to patients with T1DM (20.6 ± 6.3 years), and this difference was statistically significant (p < 0.001).

Differences between type1 and type 2 groups were noted and statistically significant for diabetes duration (6.9 ± 5.39 years vs 10.8 ± 8.55 years) (p = 0.002), symptoms duration (4 ± 6.23 days vs 7.3 ± 11.1 days) (p = 0.04) and body mass index (BMI) (19.5 ± 3.35 kg / m2 vs 23.7 ± 2.88 kg / m2) (p < 0.001).

Type 1 diabetes group was more acidotic, differences between groups are statistically significant for arterial PH (p = 0.002), and sodium bicarbonate (p = 0.04).

Patients with T1DM and T2DM remained hospitalized for an average of (3.56 ± 3.95 days vs 4.43 ± 4.17 days, p = 0.24).

Differences between groups are not statistically significant for insulin infusion duration (p = 0.89).

Six patients (4.7 %) were able to discontinue insulin therapy after a short period of time and maintain acceptable glycemic control on diet or oral agents.

Conclusions : A significant proportion of DKA occurs in patients with type 2 diabetes mellitus (T2DM).

Many cases of DKA develop without precipitating cause in patients with T2DM.

Such patients present with severe hyperglycemia and ketosis as in type 1 diabetes mellitus (T1DM) but can discontinue insulin after a few months and maintain acceptable glycemic control on diet or oral agents.

This subtype of diabetes has been referred to as ketosis-prone T2DM.