Comparing clinical characteristics and outcomes of diabetic ketoacidosis in patients type 1 and type 2 diabetes mellitus in King Narai hospital.
Keywords:
Diabetic ketoacidosis, Type 1 diabetes, Type 2 diabetesAbstract
A retrospective study was conducted on type 1 diabetes (T1DM) and type 2 diabetes (T2DM) patients who presented with diabetic ketoacidosis (DKA) and admitted at King Narai Hospital between June 1, 2019, to June 30, 2022. Data were collected from the inpatient database and the medical records in IPD charts. I included patients with biochemically confirmed DKA or euglycemic DKA (Serum ketone ≥ 3 mmol/L or urine ketone ≥ 2+, pH (arterial or venous) ≤ 7.3 or serum bicarbonate ≤ 18 mmol/L, and potentially anion gap ≥ 10 mmol/L). The study was approved by the Human Research Ethics Committee of King Narai Hospital.
Results: A total of 156 diagnosed DKA were analyzed (36 T1DM patients and 120 T2DM patients). Patients with T1DM were younger than patients with T2DM (mean age 28.36 ± 13.18 vs 53.88 ± 10.07 years, p-value 0.003). Patients with T2DM had a higher body mass index than patients T1DM. Initial plasma blood glucose was significantly higher in patients with T1DM compared to those with T2DM (554.58 ± 214.37 vs 437.02 ± 198.35 mg/dL, p-value 0.041). The main precipitating factor of DKA in both groups were infections. For the treatment of DKA, the mean volume of fluid replacements and the mean insulin requirements were not different between group. But patients with T1DM received a higher of potassium replacements, while those with T2DM received more NaHCO3. After treatment, there was no difference in resolution time of DKA management between both groups. Patients with T2DM had a significantly longer length of stay more than the other group (6.03 ± 2.96 vs 5.44 ± 2.79 days, p-value 0.039). Hypoglycemia occurred in patients with T1DM more than patients with T2DM (14 of 36 patients vs 29 of 120 patients, p-value 0.018). The overall mortality rate of DKA was 3%
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