Rashid Muhammad Owais, Sheikh Aisha, Salam Abdus, Farooq Saad, Kiran Zareen, Islam Najmul
Aga Khan University Hospital Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Jul-Sep;29(3):398-402.
Diabetes is undoubtedly one of the most challenging health problems of the 21st century. It is well known that diabetes once develop can lead to several complications. Diabetic ketoacidosis (DKA) is one of the life-threatening complications of diabetes. This study was designed to determine the frequency of DKA in diabetes patients and find out the clinical and biochemical determinants of DKA.
This descriptive study was conducted at Aga Khan University Hospital (AKUH) Karachi, Pakistan from January 2010 to February 2016. All known or newly diagnosed diabetic patients of >16 years of age irrespective of gender and type of diabetes were included. Information regarding patient's demographics, presenting symptoms, precipitating causes of DKA, biochemical profiles and outcome at the time of discharge was collected.
Majority (54.7%) had moderate and 12.4% had severe DKA at presentation. Previous history of DKA was found higher in type 1 diabetes patients (T1DM) (14%) as compare to (4%) type 2 diabetes patients (T2DM) (p<0.05). DKA severity was observed more (12%) in newly diagnosed (T1DM) (p<0.05). Comorbidities were found more (81%) in (T2DM) (p<0.05) Mortality was also observed higher in Type 2 diabetes patients (p<0.05).
Majority of the diabetics had moderate to severe DKA at presentation. Mortality and morbidity related with DKA was found considerably higher among patients with T2DM while infection, myocardial infarction and stroke found as triggering factors in these patients.
糖尿病无疑是21世纪最具挑战性的健康问题之一。众所周知，糖尿病一旦发展会导致多种并发症。糖尿病酮症酸中毒（DKA）是糖尿病危及生命的并发症之一。本研究旨在确定糖尿病患者中DKA的发生率，并找出DKA的临床和生化决定因素。
本描述性研究于2010年1月至2016年2月在巴基斯坦卡拉奇的阿迦汗大学医院（AKUH）进行。纳入所有年龄大于16岁的已知或新诊断的糖尿病患者，不分性别和糖尿病类型。收集有关患者人口统计学、出现症状、DKA的诱发原因、生化指标以及出院时结局的信息。
大多数患者（54.7%）初诊时为中度DKA，12.4%为重度DKA。1型糖尿病患者（T1DM）中既往有DKA病史的比例（14%）高于2型糖尿病患者（T2DM）（4%）（p<0.05）。新诊断的（T1DM）患者中观察到的DKA严重程度更高（12%）（p<0.05）。2型糖尿病患者（T2DM）中合并症更多见（81%）（p<0.05）。2型糖尿病患者的死亡率也更高（p<0.05）。
大多数糖尿病患者初诊时为中度至重度DKA。在2型糖尿病患者中，与DKA相关的死亡率和发病率相当高，而感染、心肌梗死和中风是这些患者的触发因素。
