Endocrine Abstracts

Background: 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% type1 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%), gastoentritis (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 creatinin, duration for recovery from DKA, type of DM and presence of coma were associated with mortality in these patients. Logestic regression revealed that duration for recovery from DKA was the only independent risk factor for mortality among diabeticswithDKA.

Conclusion: Most of diabetics with DKA are young, females and have type1 DM. Non-compliance and infection were the leading precipitating causes for DKA among type1 and type2 respectively. Recurrent admission for DKA and delayed diagnosis of new onset type1 DM are frequent and may indicate inadequate education. Respiratory and urinary tract infections 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 creatinin, type 2 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.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.