Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India
Aim: Diabetic ketoacidosis (DKA) is a dreadful complication of diabetes mellitus characterized by a biochemical triad of hyperglycemia, ketosis, and metabolic acidosis. The clinic-epidemiologic pattern and outcomes of DKA in the Indian subcontinent are largely unexplored, yet understanding them is c...
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Elsevier
2024-09-01
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| Series: | Endocrine and Metabolic Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666396124000487 |
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| author | Shubhadeep Paul Sourav Debnath Anurag Kumar Singh Shivang Mishra Sumit Rajotiya Mahaveer Singh Rahul Parashar Pusparghya Pal Sachin Kumar |
| author_facet | Shubhadeep Paul Sourav Debnath Anurag Kumar Singh Shivang Mishra Sumit Rajotiya Mahaveer Singh Rahul Parashar Pusparghya Pal Sachin Kumar |
| author_sort | Shubhadeep Paul |
| collection | DOAJ |
| description | Aim: Diabetic ketoacidosis (DKA) is a dreadful complication of diabetes mellitus characterized by a biochemical triad of hyperglycemia, ketosis, and metabolic acidosis. The clinic-epidemiologic pattern and outcomes of DKA in the Indian subcontinent are largely unexplored, yet understanding them is crucial for optimizing management strategies. Methods: A total of 138 patients admitted with a DKA diagnosis were reviewed retrospectively over two years. Patient demographics, clinical history, laboratory findings, precipitating factors, and intensive care management were extracted from case files. Clinical outcomes were classified as either discharge or death. Data analysis was performed using SPSSv29. Results: The mean age of the patients was 41.54 (16) years; 77 (55.79 %) were female, 56.52 % had type 1, 23.19 % had type 2, and 20.29 % had pancreatic diabetes. Non-compliance with infection (21.02 %), and pancreatitis (21.01 %) were common DKA triggers. Severity was assessed by pH, anion gap, and bicarbonate levels. The overall mortality rate was 11.59 %. Factors significantly associated with mortality included age >60 years, >3 previous DKA episodes, hypokalaemia, elevated serum creatinine, and altered sensorium. Conclusion: These findings emphasize the importance of demographics and risk factors in assessing DKA mortality risk, aiding early identification and targeted interventions for high-risk patients. |
| format | Article |
| id | doaj-art-786e26f5535f4521a43423220b85393f |
| institution | Kabale University |
| issn | 2666-3961 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Endocrine and Metabolic Science |
| spelling | doaj-art-786e26f5535f4521a43423220b85393f2024-12-07T08:28:35ZengElsevierEndocrine and Metabolic Science2666-39612024-09-0116100204Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in IndiaShubhadeep Paul0Sourav Debnath1Anurag Kumar Singh2Shivang Mishra3Sumit Rajotiya4Mahaveer Singh5Rahul Parashar6Pusparghya Pal7Sachin Kumar8Department of Endocrinology, NIMS Hospital, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Pharmacy Practice, Nims Institute of Pharmacy, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Pharmacy Practice, Nims Institute of Pharmacy, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Pharmacy Practice, Nims Institute of Pharmacy, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Pharmacy Practice, Nims Institute of Pharmacy, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Endocrinology, NIMS Hospital, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India; Corresponding author at: Department of Endocrinology, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India.Department of Endocrinology, NIMS Hospital, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Pharmacy Practice, Nims Institute of Pharmacy, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaDepartment of Pharmacy Practice, Nims Institute of Pharmacy, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, IndiaAim: Diabetic ketoacidosis (DKA) is a dreadful complication of diabetes mellitus characterized by a biochemical triad of hyperglycemia, ketosis, and metabolic acidosis. The clinic-epidemiologic pattern and outcomes of DKA in the Indian subcontinent are largely unexplored, yet understanding them is crucial for optimizing management strategies. Methods: A total of 138 patients admitted with a DKA diagnosis were reviewed retrospectively over two years. Patient demographics, clinical history, laboratory findings, precipitating factors, and intensive care management were extracted from case files. Clinical outcomes were classified as either discharge or death. Data analysis was performed using SPSSv29. Results: The mean age of the patients was 41.54 (16) years; 77 (55.79 %) were female, 56.52 % had type 1, 23.19 % had type 2, and 20.29 % had pancreatic diabetes. Non-compliance with infection (21.02 %), and pancreatitis (21.01 %) were common DKA triggers. Severity was assessed by pH, anion gap, and bicarbonate levels. The overall mortality rate was 11.59 %. Factors significantly associated with mortality included age >60 years, >3 previous DKA episodes, hypokalaemia, elevated serum creatinine, and altered sensorium. Conclusion: These findings emphasize the importance of demographics and risk factors in assessing DKA mortality risk, aiding early identification and targeted interventions for high-risk patients.http://www.sciencedirect.com/science/article/pii/S2666396124000487Diabetic ketoacidosisDemographicsOutcomesPrecipitating factorsMortality |
| spellingShingle | Shubhadeep Paul Sourav Debnath Anurag Kumar Singh Shivang Mishra Sumit Rajotiya Mahaveer Singh Rahul Parashar Pusparghya Pal Sachin Kumar Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India Endocrine and Metabolic Science Diabetic ketoacidosis Demographics Outcomes Precipitating factors Mortality |
| title | Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India |
| title_full | Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India |
| title_fullStr | Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India |
| title_full_unstemmed | Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India |
| title_short | Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India |
| title_sort | epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in india |
| topic | Diabetic ketoacidosis Demographics Outcomes Precipitating factors Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2666396124000487 |
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