Epidemiology of diabetic ketoacidosis in national institute of diabetes and endocrinology (NIDE)‎

Abstract EN

Aims : diabetic ketoacidosis (DKA) is the most serious acute metabolic complications of diabetes.

Unfortunately, there is a dearth of published data on this entity from Egypt.

The aim of our work was to determine the clinical characteristics, precipitating causes and mortality rate of patients with diabetic ketoacidosis in National Institute of Diabetes and Endocrinology.

Methods: Our work is a retrospective study in which we reviewed and analyzed the data of all patients (1297 diabetics: 85.8% type and 14.2% type2 diabetics, 59.6% females and 40.4% males) who admitted to NIDE in Cairo, Egypt with diagnosis of DKA over the last three years.

The mean age of the patients was 22.9 ± 15.6 year and the mean duration of DM was 5.5 ± 5.7 year.

Results: DKA among our study diabetics was attributed to non-compliance (45.5%), infection (27.2%) ,myocardial infraction (6.4%), and new-onset type 1 diabetes (20.9%).Respiratory infection (46.9%), urinary tract infection (36.3%), gastroenteritis ( 9.7%), diabetic foot (2.5%) and abscess (4.6%) were the most frequent infection in the our patients.

The patient's age, weight, blood pressure, pulse, serum creational, duration for recovery from DKA, type of DM and presence of coma were associated with mortality in these patients.

Logistic regression revealed that duration for recovery from DKA was the only independent risk factor for mortality among diabetics with DKA. Conclusion : most of diabetics with DKA are young, females and have type DM.

Non-compliance and infection were the leading precipitating causes for DKA among type and type2 respectively.

Recurrent admission for DKA and delayed diagnosis of new onset type DM are frequent and may indicate inadequate education.

Respiratory and urinary tract infection accounted for the majority of infections in these patients.

Mortality was infrequent finding among our diabetics with DKA.

Although young age, underweight, tachycardia, hypotension, high serum creational, type2 DM, rapid recovery from DKA and coma were associated with higher mortality rate among patients with DKA, rapid recovery from DKA was the only independent risk factor (predictor) for mortality in these patients.