Cetoacidosis diabética en adultos: causas y su manejo en un hospital regional / Management of diabetic ketoacidosis: retrospective analysis of 117 episodes

ABSTRACT

Background: In 2005, the Chilean Ministry of Health developed Clinical Guidelines to ensure the correct diagnosis and acute treatment of diabetic ketoacidosis (DKA). Aim: To analyze the real impact of the use of the Clinical Guidelines, comparing the diagnosis and treatment of DKA beforeand after 2005. Patients and Methods: Retrospective analysis of clinical records of adults with DKA, treated between 2001 and 2008 in a regional hospital. Results: One hundred seventeen DKA episodes, that occurred in 82 patients aged 15 to 90 years (47 percent females), were analyzed. Eightytwo percent of patients were known diabetics. Treatment discontinuation was the cause of DKA in 37 percent of patients, followed by infections in 37 percent and onset of diabetes mellitus in 17 percent. Ninety seven percent of patients previous episode of DKA were using insulin. Two patients died (1.7 percent) and DKA complications were uncommon. Bicarbonate and potassium were over prescribed despite therecommendation of Clinical Guidelines (p < 0.05). The use of infusion pumps increased after the incorporation of the Clinical Guidelines. Conclusions: A low impact of Clinical Guidelines on themanagement of DKA was observed in this group of patients. Insulin users have a higher risk for developing DKA.