CLINICAL FEATURES OF DIABETIC KETO ACIDOSIS INDIVIDUALS IN THE INTENSIVE CARE UNIT

Abstract

Background: Diabetic ketoacidosis (DKA) is the most common acute hyperglycemic condition related to diabetes. Recent investigations suggest that DKA affects approximately 8 out of every 1,000 diabetics annually.  Objective: This study aims to determine the clinical features of individuals with severe DKA admitted to ICU. Study Design: A retrospective analysis. Setting: The study was conducted at Bahria International Hospital Lahore and Services Institute of Medical Sciences Lahore, Pakistan. Duration of Study: The study period was from Oct 01, 2022, to March 30, 2023. Methods: Data from patients' health records were retrospectively analysed, including demographics, clinical manifestations (fever, nausea, vomiting, abdominal pain, breathlessness, altered sensorium, low blood pressure), and triggering factors (insulin discontinuation, septicemia). Hospital stay duration, mortality rate, and usage of mechanical ventilation were also documented. Results: A total of 30 patients were enrolled in the study, of whom 26 (86.6%) were males. The most prevalent complaint was abdominal discomfort, observed in 86.6% of the study population. Vomiting was present in 93.3% of the individuals. Only 8 (26.6%) patients were newly diagnosed with diabetes, while the remainder were known type 1 diabetics on insulin treatment. The mean HbA1c was 10.2%, ranging from 8.7% to 12.6%. Serum blood glucose, bicarbonate levels, and anion gap were independently associated with clinical indicators of severe DKA. A correlation was found between DKA indicators and the requirement for mechanical ventilation. Conclusion: The majority of individuals with severe DKA admitted to our ICU experienced gastrointestinal symptoms, with noncompliance to insulin treatment being the primary cause of DKA.