Treatment Outcome of Diabetic Ketoacidosis Among Patients Atending General Hospital in North-West Ethiopia: Hospital Based Study

Abegaz, TM; Ga, Mekonnen; Gebreyohannes, EA; Ka, Gelaye

doi:10.1101/441964

Cited by 8 publications

(8 citation statements)

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“…Another study could be conducted to evaluate the overall trend of DKA management and outcomes in prospective approach. Part of this manuscript was presented as a preprint to research square and bioRxiv but not published in any journal as original article [ 59 , 60 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of diabetic ketoacidosis among diabetes patients in Ethiopia. Hospital-based study

et al. 2022

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Background There was limited data on treatment outcomes among patients with diabetic ketoacidosis (DKA) in Ethiopia. Objective The aim of the study was to determine the treatment outcomes of DKA patients attending Debre Tabor General Hospital. Method A retrospective study was conducted at Debre Tabor General Hospital and data were collected from June 1 to June 30 of 2018. Participants included in the study were all diabetic patients with DKA admitted from August 2010 to May 31, 2018. The primary outcomes were the treatment outcomes of DKA including (in-hospital glycemic control, the length of hospital stay and in-hospital mortality). The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics was presented in the form of means with standard deviation and binary regression was conducted to determine factors that affect length of hospital stay among DKA patients. Result 387 patients were included in the study. The mean age of patients was 33.30± 14.96 years. The most common precipitating factor of DKA was new onset diabetes mellitus 150(38.8%). The mean length of hospital stay was 4.64(±2.802) days. The mean plasma glucose at admission and discharge was 443.63(±103.33) and 172.94 (±80.60) mg/dL, respectively. The majority 370 (95.60%) of patients improved and discharged whereas 17 (4.40%) patients died in the hospital. Patients with mild and moderate DKA showed short hospital stay; AOR: 0.16 [0.03–0.78] and AOR:0.17[0.03–0.96] compared with severe DKA. Diabetic ketoacidosis precipitated by infection were nearly five times more likely to have long hospital stay than DKA precipitated by other causes; AOR: 4.59 [1.08–19.42]. In addition, serum glucose fluctuation during hospitalization increased the likelihood of long hospital stay, AOR: 2.15[1.76–2.63]. Conclusions New onset type 1 diabetes was the major precipitating factor for DKA. Admitted DKA patients remained in hospital for a duration of approximately five days. About five out of hundred DKA patients ended up with death in the hospital. Infection, serum glucose fluctuations and severity of DKA were determinants of long hospital stay. Early prevention of precipitating factors and adequate management of DAK are warranted to reduce length of hospital stay and mortality.

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Section: Discussionmentioning

confidence: 99%

Treatment outcomes of diabetic ketoacidosis among diabetes patients in Ethiopia. Hospital-based study

et al. 2022

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“…The results of DKA resolution differ from a study done in Thailand whose median time of DKA resolution was 8.5hrs (Thewjitcharoen et al, 2019), another study in Melbourne had a median time of resolution of DKA of 11hrs and a median length of hospital stay being 3 days (Lee, Calder, Santamaria, & MacIsaac, 2018), the study in KNH recorded a median time of resolution of DKA to be 59hrs (2.5 days) and a study in Ethiopia recorded the mean length of hospital stay as 4.6 days (Abegaz et al, 2018).…”

Section: Discussionmentioning

confidence: 79%

Precipitating factors, presentation and outcomes of diabetic ketoacidosis among patients seen at moi teaching and referral hospital, eldoret kenya

Msagha,

Kamano,

Ayuo

2024

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PRECIPITATING FACTORS, PRESENTATION AND OUTCOMES OF DIABETIC KETOACIDOSIS AMONG PATIENTS SEEN AT MOI TEACHING AND REFERRAL HOSPITAL, ELDORET KENYA. Clemence Msagha1, Jemima Kamano2, Paul Ayuo3 Background: Diabetes Ketoacidosis (DKA) is a major complication of Diabetes Mellitus (DM) with a likelihood of high mortality if not managed appropriately. It is diagnosed with a triad of hyperglycemia, ketonemia and metabolic acidosis. Objectives: To describe the precipitating factors, clinical presentation and outcomes of DKA among patients attending Moi Teaching and Referral Hospital (MTRH). Methods: This prospective study involved 120 consecutively recruited participants diagnosed with DKA. Participants were drawn from the Emergency department and Diabetes Outpatient clinic and followed up in the wards and intensive care unit (ICU) in MTRH for up to 10 days. Focused history and physical examination was done. Blood sugar was measured daily; blood ketones and blood gases were measured on days 1,2,3 and 5. Precipitating factors, presentation and outcomes were summarised as frequencies and their corresponding percentages and presented in tables and charts. Results: The median age of participants was 33 years (IQR 23, 44.5). Type 1 DM represented 63.3% and type 2 DM 34.2% of the patients. The most common precipitating factors for DKA were; new onset undiagnosed DM (37.5%), missed medication (36.7%) and infection (35.8%). The most common presentation was dehydration (97.5%) with 49.2% of the patients having severe DKA while 22.5% had mild DKA. Urine and blood ketones for diagnosis of DKA were present in 46.4% and 100% of patients respectively. The median length of hospital stay was 6 days (IQR 5,7) with infection being a significant determinant (aOR 2.63). The number of days taken for DKA to resolve ranged from 1 to 5 days with a median period of 3 days (IQR 2,3). DKA in-hospital mortality was 9.2% with new onset DM being a significant determinant (uOR 5.19). Conclusion: Some of the identified DKA precipitants in the study are preventable. The impact of DKA in MTRH is notable given the significant hospital stay and mortality. Recommendation: We recommend implementation research studies that would develop and test different strategies to address the precipitants to prevent DKA. For the hospital to undertake an audit of current DKA management process with the aim of improving outcomes in terms of hospital stay and mortality.

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“…Diabetes Mellitus (DM) is a group of glucose metabolism characterized by high blood glucose levels [1]. There are both short and long-lasting impacts of this long-term, chronic illness.…”

Section: Introductionmentioning

confidence: 99%

Contributing Clinical Presentation, Risk Factors, and Outcomes for Diabetic Ketoacidosis Patients: A Single-Center Retrospective Study

Alsukhayri¹,

Biek²,

Khozana³

et al. 2022

Int J Pharm Res Allied Sci

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In patients with diabetes mellitus, diabetic ketoacidosis (DKA) is the most common acute metabolic complication and occurs more frequently in those with type 1 diabetes (DM1). DKA is a hyperglycemic crisis that develops due to insulin insufficiency. It can be due to insulin noncompliance, newly diagnosed diabetes mellitus, a subtherapeutic dose, and conditions that cause hyperglycemia leading to elevated ketone bodies (e.g., urinary/ respiratory tract infections), and some drugs. As reported by the World Health Organization in 2014, Saudi Arabia ranks seventh highest in the world for diabetes prevalence. The high prevalence of diabetes in Saudi Arabia contributes to the high incidence of patients with DKA. To evaluate the precipitating risks of DKA in diabetic patients and its clinical presentation and outcomes at King Faisal Hospital at Makkah in Saudi Arabia. A retrospective review of patients with (DM1) at King Faisal Hospital in Makkah who presented with DKA from September 2020 to February 2022 was performed. Symptoms and risk factors were compared across age and sex. We found that the symptoms of polyuria, nausea and vomiting, weight loss, and fever significantly differed at the 10% level depending on the patient's age. No signs were statistically significant concerning sex. Of the precipitating factors, patient failure to comply, inadequate insulin dose, and infections were statistically significant in the older age group. It was observed that missed insulin doses, high random blood sugar, and pH less than 7.3 were the most significant predictors of DKA recurrence.

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Treatment Outcome of Diabetic Ketoacidosis Among Patients Atending General Hospital in North-West Ethiopia: Hospital Based Study

Cited by 8 publications

References 24 publications

Treatment outcomes of diabetic ketoacidosis among diabetes patients in Ethiopia. Hospital-based study

Treatment outcomes of diabetic ketoacidosis among diabetes patients in Ethiopia. Hospital-based study

Precipitating factors, presentation and outcomes of diabetic ketoacidosis among patients seen at moi teaching and referral hospital, eldoret kenya

Contributing Clinical Presentation, Risk Factors, and Outcomes for Diabetic Ketoacidosis Patients: A Single-Center Retrospective Study

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