Efficacy of Initial Lactate and Lactate Clearance by Emergency Department Treatment in Diabetic Ketoacidosis Patients

ABSTRACT

PURPOSE: Diabetic ketoacidosis (DKA) is a fatal complication caused by unregulated diabetes. Lactate is used as a prognostic indicator for a range of serious illnesses and its level is higher in DKA patients. This study examined the utility of lactate and lactate clearance measurements at an emergency department for predicting the prognosis of DKA patients. METHODS: This was a retrospective, observational study of patients with DKA presenting to the emergency department of an urban and rural tertiary hospital between January, 2013 and December, 2016. The demographic and laboratory data were collected through a chart review. RESULTS: Seventy-six patients with DKA were included. Of these 76 patients, 46 (56.8%) had lactic acidosis (lactate >2.5 mmol/L) and 24 (29.6%) had a high lactate level (>4 mmol/L). Lactate and lactate clearance showed a significant difference in terms of the intensive care unit length of stay and mortality. CONCLUSION: Lactate and lactate clearance measurements in DKA patients are favorable and significant prognostic factors. In DKA patients, serial measurements of lactate should be considered.