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

Abstract

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.

Projection of diabetes morbidity and mortality till 2045 in Indonesia based on risk factors and NCD prevention and control programs

“…Case fatality rate of Diabetes was 2.32% for diabetes, proportion of death due to stroke, ischemic heart disease, and chronic kidney disease among Diabetes cases was 12.08%, 8.15%, and 6.7% respectively. Meanwhile, assumption of neuropathy due to diabetes was 53.64% 22 , retinopathy was 30.7% 23 , and Diabetes Keto Acidosis (DKA) among diabetes cases was 3,07% 24 and its mortality for 72 h was 28.57% 25 . Projection was made in three scenarios, namely scenario without intervention (scenario 1), scenario with program intervention of village with Posbindu and SPM of Diabetes services each 100% coverage (scenario 2), and scenario with program intervention and halt of the rate of risk factors (overweight, obesity, central obesity, and fatty food consumption) as condition in 2018.…”

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

“…Penyebab yang memungkinkan ialah kurangnya pengetahuan pasien DM mengenai gejala KAD sehingga pasien terlambat dibawa ke rumah sakit dan berakibat pada semakin parahnya KAD (Alanazi et al, 2018). Selain itu, RSD Dr. Soebandi Jember dimana data penelitian ini diambil adalah rumah sakit rujukan utama di Jember dan sekitarnya sehingga mayoritas pasien cenderung memiliki penyakit yang lebih parah guna mendapatkan perawatan dan terapi lebih lanjut (Dewata et al, 2020). Jumlah sampel perempuan pada penelitian ini (85,3%) lebih banyak dibandingkan sampel laki-laki (14,7%) dan sesuai dengan penelitian sebelumnya di Indonesia (Suwarto et al, 2014;Siregar et al, 2018;Dewata et al, 2020;Novida et al, 2021).…”

“…Selain itu, RSD Dr. Soebandi Jember dimana data penelitian ini diambil adalah rumah sakit rujukan utama di Jember dan sekitarnya sehingga mayoritas pasien cenderung memiliki penyakit yang lebih parah guna mendapatkan perawatan dan terapi lebih lanjut (Dewata et al, 2020). Jumlah sampel perempuan pada penelitian ini (85,3%) lebih banyak dibandingkan sampel laki-laki (14,7%) dan sesuai dengan penelitian sebelumnya di Indonesia (Suwarto et al, 2014;Siregar et al, 2018;Dewata et al, 2020;Novida et al, 2021). Perempuan rentan mengalami obesitas karena kecenderungan fisiologis untuk menyimpan lemak di tubuh.…”

“…Setelah perempuan mengalami menopause, terjadi pergeseran jaringan adiposa menuju daerah viseral yang meningkatkan risiko sindrom metabolik. Menopause juga menyebabkan defisiensi hormon estrogen yang dapat menimbulkan resistensi insulin (Dewata et al, 2020). Di samping itu, kasus DM di Indonesia lebih banyak dilaporkan pada perempuan (1,8%) daripada laki-laki (1,2%) sehingga risiko perempuan mengalami komplikasi diabetes seperti KAD juga tinggi (Kemenkes, 2018).…”

“…Sampel penelitian ini memiliki rentang umur 25-70 tahun dengan rata-rata usia 50,79 ± 12,10 tahun. Data ini hampir sama dengan penelitian oleh Seth et al (2015) di India yang menghasilkan rata-rata usia pasien KAD 51,46 tahun dan penelitian oleh Dewata et al (2020) di Indonesia dengan ratarata usia pasien KAD 49,51 ± 13,88 tahun. Data usia sampel ini kemudian dibagi menjadi dua kelompok yaitu kelompok umur <45 tahun dan ≥45 tahun untuk menilai kecenderungan frekuensi KAD yang dibagi berdasarkan kelompok umur pada derajat keparahan KAD.…”