CLINICAL AND BIOCHEMICAL CHARACTERISTICS OF DIABETIC KETOACIDOSIS: A RETROSPECTIVE ANALYSIS OF PATIENT PRESENTATION AND MANAGEMENT OUTCOMES"

Abstract

Background: Diabetic ketoacidosis (DKA) is a severe and potentially life-threatening complication of diabetes mellitus characterized by hyperglycemia, ketonemia, and metabolic acidosis. Understanding its clinical and biochemical features is crucial for effective management and improved patient outcomes.

Aim: This study aimed to evaluate the clinical presentation and biochemical characteristics of patients with DKA to enhance diagnostic accuracy and management strategies.

Methods: We conducted a retrospective analysis of 150 patients diagnosed with DKA at a tertiary care hospital over a one-year period. Data collected included patient demographics, presenting symptoms, blood glucose levels, serum ketone concentrations, arterial blood pH, bicarbonate levels, and electrolyte abnormalities. Inclusion criteria were a diagnosis of DKA based on clinical and laboratory findings, while exclusion criteria included hyperosmolar hyperglycemic state, significant metabolic or endocrine disorders, pregnancy, and incomplete records.

Results: The median age of patients was 45 years, with a gender distribution of 60% female and 40% male. The median blood glucose level was 320 mg/dL, and median serum ketones were 4.5 mmol/L. The median arterial pH was 7.2, and median bicarbonate level was 12 mEq/L. Electrolyte abnormalities were noted in 35% of patients with hypokalemia and 25% with hyperkalemia. Nausea (80%), vomiting (75%), and abdominal pain (65%) were the most common symptoms. Infections were identified as a trigger in 40% of cases. The average length of hospital stay was 5 days, with treatment outcomes showing 85% improvement, 10% stable, and 5% complicated cases.

Conclusion: The study highlights the prevalent clinical and biochemical abnormalities in DKA patients, with significant variations in presentation and management needs. Real-time monitoring of key parameters, including blood glucose, ketones, and electrolytes, is essential for effective treatment. The findings underscore the importance of early detection and tailored management strategies to improve patient outcomes in DKA.

Keywords: Diabetic ketoacidosis, blood glucose, serum ketones, arterial pH, bicarbonate, electrolyte imbalances, diabetes mellitus...