Endocrine Abstracts

Diabetic ketoacidosis (DK) is one of the most serious complications of diabetes mellitus (DM). We performed a case review of DK patients admitted to the intensive care unit (ICU) of our Hospital between 1 June 2012 and 30 June 2016. A demographic analysis was made, time of DM evolution, the therapy and the factors that led to its decompensation. Thus, a total of 42 DK patients were admitted to the ICU in the referred period, mean age was 45 years, a clear predominance of female patients (67%) and Caucasian patients (76.7%). The majority of the patients were type 1 diabetics (57%), 40% were diabetic type 2 and 3% had a diagnosis of diabetes secondary to corticosteroids. The mean duration of the disease was 12 years, and diabetes was previously unknown in 12% of the patients, where appears as an inaugural diagnosis. The mean HbA1c value of these patients was 12.6%. Regarding the treatment, 64% of the patients were exclusively treated with insulin, 21% only with oral antidiabetics and 12% did not do any type of therapy, considering that the disease was not known. Half of the patients presented nausea and vomiting, and prostration was the second most frequent presentation (33%). Infection was the most common decompensation factor (50%), followed by therapeutic failure (40%). Add that, 21% of patients required ventilatory support, 19% needed vasopressor support and only 2.3% of the patients were dialyzed. This review shows that despite all the teachings and warnings about the disease and its severity, many patients maintain a poor understanding of it, and it continues to be necessary to develop strategies to improve adherence to therapy and to achieve a better metabolic control.