Diabetic ketoacidosis in a hospital based population in Pakistan

ABSTRACT

Sixty-two consecutive episodes of diabetic ketoacidosis [DKA] were studied at Aga Khan University Hospital, Karachi. Forty-four [71%] were type I and 18 [29%] type II diabetics. Mean age was 28.1 years and mean duration of diabetes 4.1 years. Infections were the most common precipitating factor accounting for 28 episodes [45.2%]. Twenty-two patients [35.5%] had hyperosmolality [serum osmolality > 320 mosmol/L]. Mean serum Na[+] was 131.7 mmol/L and K[+] 4.6 mmol/L. Twenty-three [37.1%] were hyperkalemic at presentation with seven patients [11.3%] being comatosed and 35 [56.5%] alert. Mean random blood glucose [RBG] was 624 mg/dl, mean pH 7.09, osmolality 316 mosmol/L and the neurological status correlated statistically significantly with mean RBG, pH and osmolality. A leukemoid response was seen in 83.9% episodes. Mortality rate was 8.0% in patients with DKA managed in this hospital