A STUDY OF THE CLINICAL PROFILE OF THE DIABETIC KETOACIDOSIS CASES ADMITTED IN THE IMCU IN THE YEAR 2010

Abstract

Diabetes has reached an epidemic
proportion in India, reaching 57
million in 2010 and expected to reach 90
millions in another 20 years. Indians develop
diabetes at a young age and develop
the vascular complications in the
productive years of their lives. Acute
complications of diabetes namely diabetic
ketoacidosis (DKA), hyperglycaemic
hyperosmolar state, hypoglycaemia
and lactic acidosis are also on the raise.
In type I diabetes, before the advent of
insulin the mortality rate due to these
complications was almost 100 percent.
The mortality rate has come down drastically
to 10 percent in this century. DKA is
one of the most serious treatable acute
complications of diabetes. We decided to
study the clinical profile of DKA patients
admitted in IMCU of our hospital, in the
study period of one year from January
2010 to December 2010 by retrospective
analytical epidemiological study, analysing
the case sheets of the DKA patients
admitted in the IMCU during that period.
Totally there were 208 diabetic
complications admitted, of which DKA was
73 cases. Analysing all the case sheets we
conclude that DKA is the most common
diabetic complication at 35 percentage, followed
by hypoglycaemia, CVA and
CAHD.There are more incidences among
male and most cases are above 60 years
of age.55 percent of the patients had presented
with DKA within the first five years
of diagnosis.In 92 percent of type I diabetics
presenting with DKA, non availability of
insulin is the precipitating factor.In type II
diabetes, non availability of medication, infections
and macro vascular complications
forms equal precipit ating factors.
Hypertension was the most common
co morbid condition, control of which is
very essential.Co morbid conditions were
common in males with DKA, particularly
those above 60 years.Most deaths were in
males and in age group above 60, due to
associated co morbid conditions. So we
conclude that motivating the patients to adhere
to their medication, with regular monitoring
of their blood glucose levels forms
the corner stone to prevent this dreaded
complication.