Epidemiology of infection as a precipitating factor for diabetic ketoacidosis at Tanta University Hospital

Hamed, Zeinab Shafeek Shafeek; Gawaly, Amr M.; Abbas, Khalil Mohamed; Ahwal, Loai Mohamed El

doi:10.4103/tmj.tmj_10_17

Cited by 8 publications

(7 citation statements)

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“…Infection was the most precipitating factor (88.89%) in DKA patients. This is in accordance with Hamed, Gawaly, Abbas, & El Ahwal (2017) and Seth, Kaur, & Kaur (2015). The most common types of infection experienced by DKA patients in RSUD Dr. Soetomo were sepsis (92.86%), pneumonia (30.36%), and UTI (23.21%).…”

Section: Discussionsupporting

confidence: 84%

“…The most common types of infection experienced by DKA patients in RSUD Dr. Soetomo were sepsis (92.86%), pneumonia (30.36%), and UTI (23.21%). These results are consistent with Hamed, Gawaly, Abbas, & El Ahwal (2017) and Seth, Kaur, & Kaur (2015). In a study conducted at Cipto Mangunkusumo Hospital, Jakarta, approximately 58% of the DKA patients had infection as a precipitating factor, and more than half (51%) were respiratory tract infections (Suwarto, Sutrisna, Waspadji, & Pohan, 2014).…”

Section: Discussionsupporting

confidence: 64%

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Profile of Diabetic Ketoacidosis Patients at Regional Public Hospital Dr. Soetomo in 2017

Dewata

Novida

Aryati

2020

JBE

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Background: Diabetic ketoacidosis (DKA) is one of many life-threatening complications of diabetes mellitus (DM), which is characterized by severe hyperglycemia, metabolic acidosis and ketonemia. This complication can eventually lead to coma and death if not treated properly. Purpose: The aim of this study is to describe the profile of the DKA patients who were at Regional Public Hospital (RSUD) Dr. Soetomo in 2017. Methods: This study was a descriptive study that used the medical record data of DKA patients who were at RSUD Dr. Soetomo in 2017. The study’s total sample size was 63 patients. The study’s variables were gender, age, type of DM, severity of DKA, precipitating factors, main complaints, vital signs, random plasma glucose level, electrolyte level, and blood gas analysis. The frequency, mean, and standard deviation were analyzed. Results: Most of the 63 DKA patients were female (66.67%), aged from 50–59 years (38.10%). The DKA cases being handled by the Dr. Soetomo Hospital were overwhelmingly of type 2 DM patients (88.89%). More than half the patients (58.73%) experienced severe DKA. Altered states of consciousness (46.03%) and shortness of breath (26.98%) were the most common main complains made by the DKA patients. Almost all patients experienced infection (88.89%) as the precipitating factor; the most common infections were sepsis (92.86%), pneumonia (30.36%), and urinary tract infections (23.21%). Two thirds of the patients (66.67%) had a length of stay of 0–7 days. About 57.14% of the DKA patients died while undergoing treatment. Conclusion: The number of severe DKA patients and the mortality rate in our study were higher than in other studies. Females and the elderly were more prone to DKA, and the most common precipitating factor was infection.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 64%

Profile of Diabetic Ketoacidosis Patients at Regional Public Hospital Dr. Soetomo in 2017

Dewata

Novida

Aryati

2020

JBE

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“… 6 It occurs primarily in patients with type 1 DM and under stressful conditions such as trauma, surgery, and/or infections it can also occur in type 2 DM. 7 It is mainly explained by hyperglycemia, ketonemia, and acidemia that can be associated along with a rising counter-regulatory hormone including cortisol, glucagon, and epinephrine. 8 , 9 Hence, patients with DKA presents with dehydration, weight loss, polyuria, polydipsia, vomiting, weakness, and change of mental status.…”

Section: Introductionmentioning

confidence: 99%

“… 11 The management of DKA includes fluid resuscitation or recurrent rehydration, electrolyte replacement, insulin therapy, and correction of exacerbating factors. 6 , 7 , 12 …”

Section: Introductionmentioning

confidence: 99%

Diabetic Ketoacidosis Management and Treatment Outcome at Medical Ward of Shashemene Referral Hospital, Ethiopia: A Retrospective Study

Taye

Bacha

Taye

et al. 2021

Clin Med Insights Endocrinol Diabetes

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Background: Diabetic Ketoacidosis (DKA) is the most common and yet potentially life-threatening acute complication of diabetes that progresses rapidly to death and requires immediate medical intervention. Objective: To assess the DKA management and treatment outcome/in-hospital mortality and its predictors among hospitalized patients with DKA at the Medical ward of Shashemene Referral Hospital (SRH). Method: A retrospective study was conducted at the Medical Ward of SRH from 01 February 2015 to 31 January 2017. A systematic random sampling technique was used to select study subjects based on the inclusion criteria. Thus, of 236 reviewed charts, only 225 patients with DKA fulfilled inclusion criteria. Treatment outcome was considered good for patients who have shown improvement at discharge, while poor for patients who left against medical advice or died in the hospital. Logistic regression analysis was done to determine independent predictors for treatment outcome/in-hospital mortality using SPSS version 20 with statistical significant at P ⩽ .05. Results: Of 225 patients with DKA, 124 (55.1%) were male. Regular insulin was prescribed to all patients and antibiotics were administered to 87 (38.7%). Potassium supplementation was given only for 28 (12.4%). Non-adherence to insulin treatment (n = 91; 40.4%) and infection (n = 66; 29.3%) were the principal DKA precipitating factors. Even though 73.8% of hospitalized patients with DKA have shown good treatment outcomes, DKA contributed 12% in-hospital mortality. The result of multivariate logistic regression analysis shown that hypoglycemia is the only independent predictor for in-hospital mortality[ P = .03]. Moreover, the independent predictors for poor DKA treatment outcome were found to be smoker [ P = .04], Urinary tract infection (UTI) relative to other co-morbid condition [ P < .001], severe hypokalemia which increase risk of poor treatment outcome by around 4 times [ P = .02], and use of Metronidazole as a concurrent medication relative to other concurrent medication [ P = .03]. Conclusion: There was a high in-hospital mortality rate due to correctable causes. This mortality is unacceptable as it was majorly related to the poor practice of potassium supplementation and hypoglycemia due to insulin. Thus, clinicians and stakeholders should have to focus on modifiable factors (hypokalemia, UTI, and hypoglycemia) to reduce poor treatment outcome/in-hospital mortality.

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“…Infeksi yang paling sering mecetuskan KAD yaitu infeksi saluran kemih (31,2%); infeksi saluran pernafasan (26,8%); infeksi saluran cerna (13,9%); infeksi jaringan kulit dan subkutan (4,3%), kaki diabetik (2,1%); infeksi telinga hidung tenggorok (8,6%); dan infeksi campuran (12,9%). 5 Pada laporan kasus terkait herpes genital sebagai pencetus KAD, digambarkan beberapa kasus herpes yang bervariasi mulai dari herpes genital yang luput dari pemeriksaan hingga herpes genital yang sudah diberi tatalaksana. Temuan ini mengindikasikan bahwa infeksi kulit seperti herpes dapat mencetuskan KAD dalam kondisi apapun.…”

Section: Diskusiunclassified

Herpes Zoster Sebagai Pencetus Ketoasidosis Diabetikum (KAD)

Suwita¹,

Johan²,

Tahapary³

et al. 2019

JPDI

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ABSTRAKKetoasidosis diabetikum (KAD) merupakan komplikasi akut diabetes yang sering dijumpai dan mengancam jiwa. KAD terjadi akibat defisiensi insulin berat dan seringkali muncul sebagai gejala pertama pada penyandang diabetes yang belum terdiagnosis meski dapat juga muncul pada individu yang sudah menyandang diabetes. Beberapa keadaan yang dapat memicu KAD antara lain infeksi, infark miokard, stroke, pankreatitis, trauma, atau kepatuhan berobat yang tidak baik. Infeksi jaringan kulit seperti herpes zoster merupakan jenis pencetus yang langka pada KAD. Artikel ini akan membahas suatu kasus KAD yang dicetuskan herpes zoster. ABSTRACT Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes which is common in daily practice.DKA is the result of severe insulin deficiency and often presents as the first symptom of an undiagnosed diabetes even though it may also appear in individuals with diabetes. Some conditions that can trigger DKA include infections, myocardial infarction, stroke, pancreatitis, trauma, or poor treatment compliance. Skin tissue infections such as herpes zoster are rare inciting factor in DKA. This article will discuss a case of DKA that is triggered by herpes zoster.

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Epidemiology of infection as a precipitating factor for diabetic ketoacidosis at Tanta University Hospital

Cited by 8 publications

References 0 publications

Profile of Diabetic Ketoacidosis Patients at Regional Public Hospital Dr. Soetomo in 2017

Profile of Diabetic Ketoacidosis Patients at Regional Public Hospital Dr. Soetomo in 2017

Diabetic Ketoacidosis Management and Treatment Outcome at Medical Ward of Shashemene Referral Hospital, Ethiopia: A Retrospective Study

Herpes Zoster Sebagai Pencetus Ketoasidosis Diabetikum (KAD)

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