Diabetic Ketoacidosis in Peruvian Patients with Type 2 Diabetes Mellitus

Pinto, Miguel E.; Villena, Jaime; Villena, Arturo

doi:10.4158/ep.14.4.442

Cited by 22 publications

(21 citation statements)

References 18 publications

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“…Previously undiagnosed diabetes, poor drug compliance, urinary tract infections, respiratory infections, and unidentifiable causes were the main precipitating factors of HE as previously documented in other studies 310–12. However, malaria was a common precipitant that was not previously emphasized.…”

Section: Discussionsupporting

confidence: 66%

“…DKA is common in type 1 diabetes mellitus (T1DM) while HHS is common in type 2 diabetes mellitus (T2DM). However, there are also reports of ketosis-prone type T2DM where patients are able to discontinue insulin therapy and remain insulin-independent 23. An epidemiologic study of hyperglycemic states has shown that occurrence of DKA varied among different ethnic groups in Texas, USA 4.…”

Section: Introductionmentioning

confidence: 99%

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Clinical profile and outcomes of adult patients with hyperglycemic emergencies managed at a tertiary care hospital in Nigeria

Edo

2012

Niger Med J

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Background:To document the clinical profile and treatment outcomes of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) managed in a tertiary care hospital.Materials and Methods:This was a retrospective review of hospital records of patients with DKA and HHS admitted to a tertiary care hospital over a 24-month period. Data on demographics, precipitating factors, clinical features, serum electrolytes, duration of hospital admission, and mortality were extracted.Results:Eighty-four patients were included in the study. Fifty (59.5%) were females. Ten (11.9%) persons had type 1 diabetes mellitus (T1DM) and 74 (88.1%) had type 2 diabetes mellitus (T2DM). There were 35 cases of DKA and 49 cases of HHS. Nine patients with T1DM presented in DKA and one in HHS. Forty-eight (55.2%) subjects were previously not diagnosed of diabetes mellitus (DM). The mean±SEM age, casual blood glucose, calculated serum osmolality, and duration of hospital stay of the study subjects were 50.59±1.63 years, 517.98±11.69 mg/dL, 313.59±1.62 mOsmol/L, and 18.85±1.78 days, respectively. Patients with T2DM were significantly older than those with T1DM (54.32±1.34 vs. 23.40±1.38 years, P<0.001).The precipitating factors were poor drug compliance 23 (27.4%), malaria 12 (14.3), urinary tract infection 10 (11.9%), lobar pneumonia 4 (4.8%), and unidentifiable in 29 (34.5%). Common electrolyte derangements were hyponatremia, 31 (36.9%) and hypokalemia 21 (25%). Mortality rate was 3.6%.Conclusion:DKA is common in patients with T2DM.Over 50% of the patients presenting with DKA or HHS have no previous diagnosis of DM. Non-compliance, malaria, and infections are important precipitants. Mortality rate is low.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Clinical profile and outcomes of adult patients with hyperglycemic emergencies managed at a tertiary care hospital in Nigeria

Edo

2012

Niger Med J

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“…13-18 Jabbar A et al 19 found that in twothird of type 2 diabetic patients, DKA was precipitated by infection and after recovery from DKA; many of them were on OADs without recurrence of DKA. This observation explains that infection can unmask previously undiagnosed type 2 diabetic patients, as reported by Pinto ME et al 17 In different studies it was found that, in up to 25% of patients with DKA precipitating cause could not be identified. 4,17 Outcome of this study showed that 6.5% patients expired in hospital.…”

Section: Discussionmentioning

confidence: 50%

“…This observation explains that infection can unmask previously undiagnosed type 2 diabetic patients, as reported by Pinto ME et al 17 In different studies it was found that, in up to 25% of patients with DKA precipitating cause could not be identified. 4,17 Outcome of this study showed that 6.5% patients expired in hospital. Almost similar results were found in two different reports from Bangladesh.…”

Section: Discussionmentioning

confidence: 50%

Pattern of Precipitating Causes of Diabetic Ketoacidosis in A Tertiary Care Hospital of Bangladesh

et al. 2018

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“…El pobre control metabólico es debido al acceso limitado al tratamiento regular dado que los pacientes deben sufragar los gastos del mismo, a la pobre adherencia a la dieta y a hábitos de vida saludable como el ejercicio, a la baja frecuencia de consultas al hospital y a que muy pocos realizan el automonitoreo de la glucosa por el costo elevado de este y generalmente cursan con múltiples complicaciones crónicas (22,23). En ese sentido, se suele observar casos de cetoacidosis diabética con bastante frecuencia en el Perú, a pesar de presentar una de las menores incidencias de diabetes tipo 1 en el mundo (17,(24)(25)(26) embargo, en nuestro estudio encontramos una tasa de mortalidad estimada considerablemente mayor (8,25%) y estaba relacionada a una edad mayor de 60 años, comorbilidades crónicas y estados severos de inestabilidad hemodinámica.…”

Section: Discussionunclassified

Características demográficas y epidemiológicas de pacientes con diabetes mellitus tipo 2 hospitalizados por cetoacidosis diabética en un hospital general de Lima-Perú

2014

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Objetivo: Describir las características demográficas y epidemiológicas de pacientes con diabetes mellitus tipo 2 hospitalizados por cetoacidosis diabética en un hospital general de Lima-Perú. Material y Métodos: Estudio observacional descriptivo, realizado en la totalidad de pacientes con cetoacidosis diabética hospitalizados entre enero de 2001 y diciembre de 2009 en el Hospital Nacional Cayetano Heredia (HNCH). Se seleccionaron pacientes mayores de 18 años con cetoacidosis diabética o diabetes mellitus, registrados en la base de datos de la Oficina de Epidemiologia del HNCH. Se exploraron las características demográficas y relacionadas a su internamiento. Los pacientes con diabetes tipo 1 fueron excluidos del estudio. Resultados: Se incluyeron 3 683 pacientes, 3 470 con diabetes tipo 2. Se identificaron 206 casos de cetoacidosis, 60,8% fueron diabéticos tipo 2; la edad promedio fue 50,6 años y la estancia hospitalaria fue 9,9 días. De las condiciones asociadas, 42,23% fueron infecciones, 13,59% enfermedad cardiovascular y en 30,58% ninguna. La tasa anual de cetoacidosis en pacientes con diabetes tipo 2 se incrementó de 3,58 a 5,80 por 100 diabéticos tipo 2 hospitalizados al año, con una mortalidad total de 8,25%. Conclusiones: En este hospital general de Lima la frecuencia de cetoacidosis diabética en pacientes con diabetes tipo 2 se ha incrementado y presenta una elevada tasa de mortalidad, especialmente en adultos mayores.

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Diabetic Ketoacidosis in Peruvian Patients with Type 2 Diabetes Mellitus

Cited by 22 publications

References 18 publications

Clinical profile and outcomes of adult patients with hyperglycemic emergencies managed at a tertiary care hospital in Nigeria

Clinical profile and outcomes of adult patients with hyperglycemic emergencies managed at a tertiary care hospital in Nigeria

Pattern of Precipitating Causes of Diabetic Ketoacidosis in A Tertiary Care Hospital of Bangladesh

Características demográficas y epidemiológicas de pacientes con diabetes mellitus tipo 2 hospitalizados por cetoacidosis diabética en un hospital general de Lima-Perú

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