Clinical characteristics and outcomes of patients with diabetic ketoacidosis of different severity

Abstract

To analyze the influencing factors and outcomes of the different severity of diabetic ketoacidosis (DKA). A total of 50 children with DKA admitted to the Department of Pediatrics, Tianjin Medical University General Hospital from January 2009 to December 2018 were included in this study. The patients were divided into mild group, moderate group, and severe group according to the severity of the disease. We then analyzed the clinical characteristics and outcomes of the 3 groups. Compared to mild and moderate DKA groups, patients with severe DKA were more likely to present chest tightness, and higher levels of blood osmotic pressure, urea, and creatinine ( P < .05). Logistic regression analysis showed that blood osmotic pressure, creatinine, and chest tightness were independent factors for severity of DKA. There was a significant difference in the resolution time of DKA among the 3 groups (mild vs moderate: 9.0 hours vs 15.25 hours; moderate vs severe: 15.25 hours vs 24.5 hours, P < .001). There were statistical differences in the decline of Glasgow score among 3 groups ( P = .004). Patients with severe DKA showed higher osmotic pressure and creatinine, as well as dyspnea. The children with severe DKA were more likely to present progression of neurological symptoms, which was necessary to pay attention to the presence of brain edema.

Análisis de las variables involucradas en el tiempo de resolución de los parámetros metabólicos en adultos con cetoacidosis diabética

“…El TRC se define como el tiempo necesario hasta alcanzar una glucemia ≤200 mg/dl, HCO 3 ≥15mN, pH≥7.3 y AG≤12 mN. Al igual que en reportes previos, 13 , 14 el TRC en nuestro estudio fue mayor en aquellos pacientes con CAD severa. Evidenciamos una correlación negativa entre el TRC, pH, bicarbonato sérico y edad, y una correlación positiva con el recuento de glóbulos blancos, AG, potasemia y volumen de cristaloides utilizados.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18], siendo mayor en la CAD grave (Tabla 2). No hubo diferencias en el TRC según el tipo de DM ni el factor desencadenante.…”

Differences of BUN and Serum Creatinine Values in Severity of Diabetic Ketoacidosis Patients at RSD dr. Seobandi Jember

“…Ketoasidosis diabetikum (KAD) merupakan salah satu krisis hiperglikemik dan komplikasi akut yang paling umum terjadi pada penderita diabetes melitus (DM) (Dhatariya et al, 2020). KAD terjadi akibat defisiensi insulin absolut atau relatif yang bermanifestasi menjadi hiperglikemia, asidosis metabolik, ketosis, dan dehidrasi (Wei et al, 2020). American Diabetes Association (ADA) consensus tahun 2018 mengklasifikasikan KAD menjadi derajat ringan, sedang, dan berat berdasarkan keparahan asidosis metabolik dan status kesadaran.…”

“…Perbedaan kadar kreatinin yang bermakna didapatkan pada dua dari tiga variasi antar derajat keparahan KAD, yaitu KAD derajat ringan dengan berat (p=0,043) dan KAD derajat sedang dengan berat (p=0,019). Hal ini didukung oleh Wei et al (2020) dan Wu et al (2020) dalam penelitiannya yang menghasilkan perbedaan bermakna dengan nilai kreatinin yang signifikan tinggi pada KAD derajat berat. Peningkatan kadar kreatinin serum menandakan penurunan volume darah dan hipoperfusi ginjal yang mencerminkan keparahan dehidrasi dan kerusakan organ tubuh, seperti pada ginjal yang kemudian dapat meningkatkan risiko AKI (Chen et al, 2020;Wei et al, 2020).…”

Integrated Wearable Sensors for Sensing Physiological Pressure Signals and β-Hydroxybutyrate in Physiological Fluids

“…Therefore, HB can be used as a biomarker of DKA. It has been reported that the HB is detected in sweat, − serum, − urine, , and tissue fluid . Clinically, the level of HB in serum is measured by a biochemical analyzer, which is time-consuming, laborious, invasive, and non-real-time detection .…”