Clinical profile and treatment outcome of diabetic ketoacidosis

Data on 143 consecutive cases with diabetic ketoacidosis (DKA) seen during the past 6 years were analysed. The group included 60 males and 83 females, aged 8-70 years (21.5 +/- 4.2). Ninety five (66.5%) were known diabetics, while 48 had DKA as the first clinical presentation. The major recognised precipitating factors were infection in 42 patients (30%) and omission of insulin in 29 patients (20%). The approximate duration of DKA prior to hospital admission ranged from 4 to 96 hours. The range of biochemical alterations on admission were: blood glucose 9.7-51.1 mmol/l, (19 +/- 4.6), potassium 3.0 to 6.9 mmol/l (5.8 +/- 1.2), sodium 132 to 148 mmol/l (138 +/- 7.5), urea 4.67 to 26.17 mmol/l (11.3 +/- 2.9) and arterial pH 6.9 to 7.34. Therapy in all patients consisted of correction of fluid and electrolyte imbalance, insulin and suitable antibiotics. Forty three patients received low dose hourly insulin while others received it in the conventional schedule. Thirty four patients (23.7%) died. The parameters which could be related to mortality included (1) duration of DKA prior to admission, (2) severity of acidosis, and (3) severity of peripheral vascular insufficiency.