Endocrine Abstracts

Objective: Diabetic ketoacidosis is one of the major complications in Diabetes. If not appropriately diagnosed and managed it could be life threatening. Our aim was to evaluate whether DKA was properly diagnosed, if prompt and appropriate treatment was initiated, to identify precipitants and to assess mortality.

Method: We audited retrospectively patients admitted with DKA between August 2004 and August 2005. Management of DKA was audited against standards set in the guidelines.

Results: We had 42 admissions due to of DKA. Seven of these 42 admissions were wrongly diagnosed as DKA on initial presentation as they were not acidotic. Five of these patients had Type 2 diabetes and 2 had Type 1 diabetes.

Infection (78%) was the most common precipitant. Poor compliance (12%) and first presentation of Type 1 diabetes (10%) were other precipitants.

Fluid replacement was adequately done in 88%. All but one of these patients was promptly started on sliding scale insulin. Only 60% had potassium replaced.

Only 1 patient was managed in ITU the rest were managed in MAU and medical wards. No deaths were reported. Median length of hospital stay was 4 days. Eighty percent of patients had education prior to discharge.

Conclusion: DKA can be adequately managed in the MAU and medical wards. It is important to correctly identify DKA, as this would alter management. Though management was appropriate with regards to fluid and insulin, potassium replacement was not adequate. It is important to identify infections, as these are the commonest precipitants. Patients education on discharge is very important.