Diabetic ketoacidosis and predisposing factors in diabetic patients
Background: Diabetic ketoacidosis is a final result of severe insulin deficiency in type 1 diabetes that occurs in 20-40% of children and it is a life-threatening complication. This phenomenon is a medical emergency and requires prompt diagnosis and treatment. The aim of this study was investigation of frequency and causes of diabetic ketoacidosis and its consequences to prevent complications.
Methods: This study was performed on 128 diabetic patients in Amirkola Children’s Hospital (1384-1392). Patient information was recorded in a predetermined questionnaire and data were then entered into SPSS version 18.0 software for statistical analysis.
Findings: Of 128 diabetic patients hospitalized in Amirkola Children’s Hospital, 54.7% of patients were male and 45.3% were female with an average age of 8.57±3.27 years. 103(80.5%) patients were referred to this hospital for the first time and did not have a history of diabetes and 25(19.5%) patients were previously treated with insulin. Of total 128 patients, 71(55.5%) had some degree of ketoacidosis; severe ketoacidosis was the most common with 28.1%. Among patients with a diagnosis of ketoacidosis (71 patients), 54 patients (76%) presented with diabetic ketoacidosis as the first symptom of diabetes. In general, the predisposing factors of ketoacidosis was seen in 38% of patients, respiratory infections 24.3%, urinary tract infections 2.8% and gastrointestinal infections 4.30%. In patients with previous diagnosis of diabetes mellitus and admission with diabetic ketoacidosis, 52.9% of them had previous treatment cessation. Complications during treatment of ketoacidosis in patients like hypokalemia 21.2%, hyperkalemia 15.4%, hyponatremia 28.1 and hypernatremia 11.2% was observed.
Conclusion: Based on the results of this study, high prevalence of ketoacidosis in our patients than any of the other studies, seem to be related to lack of informations about diabetes mellitus between population and medical field that require to universal education.