Qari Faiza
Faiza Qari, Professor of Medicine, King Abdulaziz University, Faculty of Medicine, P.O. Box 80215, Jeddah 21589, Kingdom of Saudi Arabia.
Pak J Med Sci. 2015 Nov-Dec;31(6):1463-6. doi: 10.12669/pjms.316.7550.
The aims of this study were assessing the frequency of clinical characteristics of patients with severe Diabetic ketoacidosis (DKA) who were admitted to the intensive care unit (ICU) and investigating the relationship between paraclinical (glucose, anion gap, and serum bicarbonate) and clinical parameters in patients with severe DKA.
A retrospective chart review of all adult patients with DKA who were admitted to the ICU at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 2012 and December 2013. The data collected include the demographic data, clinical presentation, precipitating factors, duration of hospital stay and mortality rate. The data were analyzed using STAT software.
A total of 60 patients were included. Of these, 50 were men (83.3%). The median age was 23 years (ranging 18-29 years). Newly diagnosed diabetics accounted for 15 (25%) of the cases; the remainder were previously known patients of type1 diabetes on treatment. The main precipitating factors of DKA were insulin treatment cessation (87.5%) and infection/sepsis (39.6%). Serum blood glucose, serum bicarbonate level, and the calculated anion gap did not significantly correlate with clinical parameters of severe DKA.
Most patients with severe DKA who were admitted to the ICU of our institution presented with gastrointestinal symptoms. Non-compliance to insulin therapy was the main precipitating factor of DKA.
本研究旨在评估入住重症监护病房(ICU)的重度糖尿病酮症酸中毒(DKA)患者的临床特征出现频率,并调查重度DKA患者的辅助检查指标(血糖、阴离子间隙和血清碳酸氢盐)与临床参数之间的关系。
对2012年1月至2013年12月期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院ICU住院的所有成年DKA患者进行回顾性病历审查。收集的数据包括人口统计学数据、临床表现、诱发因素、住院时间和死亡率。使用STAT软件对数据进行分析。
共纳入60例患者。其中,50例为男性(83.3%)。中位年龄为23岁(范围18 - 29岁)。新诊断的糖尿病患者占病例的15例(25%);其余为之前已知的1型糖尿病治疗患者。DKA的主要诱发因素是胰岛素治疗中断(87.5%)和感染/脓毒症(39.6%)。血清血糖、血清碳酸氢盐水平和计算出的阴离子间隙与重度DKA的临床参数无显著相关性。
入住我院ICU的大多数重度DKA患者有胃肠道症状。胰岛素治疗依从性差是DKA的主要诱发因素。