Endocrine Abstracts

Background/Aim: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes. Our aim was to study the clinical features of DKA and precipitating factors responsible for DKA in diabetic patients.

Methods: This is a retrospective cross-sectional descriptive study concerning all patients hospitalized in the Endocrinology Department for DKA between August 2021 and December 2021. Initial kalemia levels (k +) on presentation were determinated on AU 680® Beckman Coulter. Hypokalemia was defined using the criteria set forth by the American Diabetes Association (ADA) as measured serum potassium less than 3.3 mmol/l. The common clinical presentations, precipitating factors and the mean of Glycemia between diabetes who presented hypokaliemia (G1) and those with normal k + (G2). The data were analyzed using SPSS25.

Results: Out of 30 patients, 19 (63.3%) patients had type 1 diabetes and 11 (36.7%) had type 2 diabetes. Mean age was 26.7 ±10.4 years. There were12 (40%) males and 18 (60%) females. The mean of BMI was 20.5±3.4 kg/m². The mean potassium level was 3.73 mmol/l (range 2.3 to 5.3; SD +/- 0.72). Among patients, 26.7% (T1D:50% vs T2D:50%), had hypokalaemia (k + < 3.3 mmol/l). The mean age was 26.7 ±10.4 years (type 1 diabetes 22±6.5 years; type 2 diabetes 34.9±11 years). The most common symptoms of patients were polyuria and polydipsia seen in 56.7% (G1:37.7% vs G2:63.6%) at the first time of their admission. Nausea and vomiting, abdominal pain, fever and dehydration were observed in 43.3% (G1:75%vs G2:25%), in 26.7% (G1:62.5% vs G2:0%), in 10% (G1:12.5% vs G2:9.1%) and in 6.7% (G1:0% vs G2:9.1%) of patients, respectively. Abdominal pain, nausea and vomiting were the symptoms statistically different between the two groups (P<0.0001, P=0.035 respectively). The most common precipitating factor of DKA was therapy discontinuation seen in 43.3% of patients (G1:37.5%vs G2:45.5%), first presentation and infections were observed in 33.4% (G1:25%vs G2:36.4%). and in 23.3% (G1:37.5%vs G2:18.2%), of patients, respectively. The differences in precipitating factors of DKA between the two groups were no significant.

Conclusion: Hypokalemia was observed in 26.7% of patients with DKA. Abdominal pain, nausea and vomiting are more frequents in patients who presented hypokaliémia. Further research is needed to better determine the risks and benefits of administering insulin before obtaining serum potassium values.