Clinical Profile of Diabetic Ketoacidosis in Adults in Dhulikhel Hospital.

Background Diabetic ketoacidosis is one of the life-threatening acute complications of diabetes mellitus. Despite the improvements in diabetic care, it remains a major clinical problem in clinical practice. Objective To assess the clinical and laboratory profile of adults with diabetic ketoacidosis in Dhulikhel hospital. Method This is a descriptive cross-sectional study including adult patients admitted in Dhulikhel hospital from July 2014 to July 2016 with the diagnosis of diabetic ketoacidosis according to the guidelines of American diabetes association. The hospital records of these patients were reviewed for their clinical and biochemical profiles. Result Forty eight patients fulfilled the criteria of diabetic ketoacidosis and were included in the study. Seventy three percent of patients had type 2 diabetes mellitus. Twenty three percent of the patients were cases of newly diagnosed diabetes mellitus. Polyuria and polydipsia as presenting complaint was more common in patients with type 1 diabetes mellitus (p=0.002) whereas fever was more common in type 2 diabetes mellitus patients (p=0.03). Majority of patients had normal serum sodium and potassium level. Forty two percent of the patients have high serum urea level and just over one third had high serum creatinine level. The most common precipitating factor of diabetic ketoacidosis for patients with type 1 diabetes mellitus was omission of insulin whereas in type 2 diabetic patients was infection. Conclusion Diabetic ketoacidosis is complication of both type 1 and type 2 diabetes mellitus. High degree of suspicion is needed for early detection of this life threatening condition especially in patients without history of diabetes mellitus.