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Diabetic ketoacidosis--a study of 33 episodes.
Singapore Med J. 1993 Oct; 34(5):381-4.SM

Abstract

Twenty-six patients presenting with 33 episodes of Diabetic Ketoacidosis (DKA) and managed on a protocol oriented system were analysed. Diabetes mellitus was newly diagnosed at presentation in 18% of the 33 episodes. The presenting symptoms were polyuria and polydipsia (58%), nausea and vomiting (52%), change in sensorium (24%), hyperventilation (24%), and abdominal pain (18%). The main clinical findings at admission were dehydration (97%), acidotic respiration (67%), coma and confusion (61%), a clinically detectable source of sepsis (49%), fever (33%) and hypotension (9%). Blood sugar levels at admission ranged between 351 mg/dl and 1200 mg/dl (mean = 633 mg/dl). The mean serum potassium at diagnosis was 5.1 mmol/l and the mean calculated serum osmolality was 320 mOsm/kg. The mean serum osmolality was higher in those with disturbed conscious level. Infections, particularly those of the urogenital tract, were the main precipitating cause for the DKA. Only 12 of the 19 patients with sepsis had fever. Eight of the episodes were attributed to patients' non-compliance with insulin. Four patients died during the 33 hospitalisations, giving a mortality rate of 10%. Death occurred despite glucose control and stabilisation of the ketoacidotic state and was due to uncontrolled septicaemia. The mean duration of hospitalisation was 11 days. The ketoacidosis state was reversed after a mean duration of 9.5 hours, with an average soluble insulin requirement per patient of 52.4 units.

Authors+Show Affiliations

Department of Medicine, Alexandra Hospital, Singapore.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8153679

Citation

Rajasoorya, C, et al. "Diabetic Ketoacidosis--a Study of 33 Episodes." Singapore Medical Journal, vol. 34, no. 5, 1993, pp. 381-4.
Rajasoorya C, Wong SF, Chew LS. Diabetic ketoacidosis--a study of 33 episodes. Singapore Med J. 1993;34(5):381-4.
Rajasoorya, C., Wong, S. F., & Chew, L. S. (1993). Diabetic ketoacidosis--a study of 33 episodes. Singapore Medical Journal, 34(5), 381-4.
Rajasoorya C, Wong SF, Chew LS. Diabetic Ketoacidosis--a Study of 33 Episodes. Singapore Med J. 1993;34(5):381-4. PubMed PMID: 8153679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diabetic ketoacidosis--a study of 33 episodes. AU - Rajasoorya,C, AU - Wong,S F, AU - Chew,L S, PY - 1993/10/1/pubmed PY - 1993/10/1/medline PY - 1993/10/1/entrez SP - 381 EP - 4 JF - Singapore medical journal JO - Singapore Med J VL - 34 IS - 5 N2 - Twenty-six patients presenting with 33 episodes of Diabetic Ketoacidosis (DKA) and managed on a protocol oriented system were analysed. Diabetes mellitus was newly diagnosed at presentation in 18% of the 33 episodes. The presenting symptoms were polyuria and polydipsia (58%), nausea and vomiting (52%), change in sensorium (24%), hyperventilation (24%), and abdominal pain (18%). The main clinical findings at admission were dehydration (97%), acidotic respiration (67%), coma and confusion (61%), a clinically detectable source of sepsis (49%), fever (33%) and hypotension (9%). Blood sugar levels at admission ranged between 351 mg/dl and 1200 mg/dl (mean = 633 mg/dl). The mean serum potassium at diagnosis was 5.1 mmol/l and the mean calculated serum osmolality was 320 mOsm/kg. The mean serum osmolality was higher in those with disturbed conscious level. Infections, particularly those of the urogenital tract, were the main precipitating cause for the DKA. Only 12 of the 19 patients with sepsis had fever. Eight of the episodes were attributed to patients' non-compliance with insulin. Four patients died during the 33 hospitalisations, giving a mortality rate of 10%. Death occurred despite glucose control and stabilisation of the ketoacidotic state and was due to uncontrolled septicaemia. The mean duration of hospitalisation was 11 days. The ketoacidosis state was reversed after a mean duration of 9.5 hours, with an average soluble insulin requirement per patient of 52.4 units. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/8153679/Diabetic_ketoacidosis__a_study_of_33_episodes_ DB - PRIME DP - Unbound Medicine ER -