A STUDY OF THE CLINICAL PROFILE OF THE DIABETIC KETOACIDOSIS CASES ADMITTED IN THE IMCU IN THE YEAR 2010

Abstract : Diabetes has reached an epidemic proportion in India, reaching 57 million in 2010 and expected to reach 90 millions in another 20 years. Indians develop diabetes at a young age and develop the vascular complications in the productive years of their lives. Acute complications of diabetes namely diabetic ketoacidosis (DKA), hyperglycaemic hyperosmolar state, hypoglycaemia and lactic acidosis are also on the raise. In type I diabetes, before the advent of insulin the mortality rate due to these complications was almost 100 percent. The mortality rate has come down drastically to 10 percent in this century. DKA is one of the most serious treatable acute complications of diabetes. We decided to study the clinical profile of DKA patients admitted in IMCU of our hospital, in the study period of one year from January 2010 to December 2010 by retrospective analytical epidemiological study, analysing the case sheets of the DKA patients admitted in the IMCU during that period. Totally there were 208 diabetic complications admitted, of which DKA was 73 cases. Analysing all the case sheets we conclude that DKA is the most common diabetic complication at 35 percentage, followed by hypoglycaemia, CVA and CAHD.There are more incidences among male and most cases are above 60 years of age.55 percent of the patients had presented with DKA within the first five years of diagnosis.In 92 percent of type I diabetics presenting with DKA, non availability of insulin is the precipitating factor.In type II diabetes, non availability of medication, infections and macro vascular complications forms equal precipitating factors.Hypertension was the most common co morbid condition, control of which is very essential.Co morbid conditions were common in males with DKA, particularly those above 60 years.Most deaths were in males and in age group above 60, due to associated co morbid conditions. So we conclude that motivating the patients to adhere to their medication, with regular monitoring of their blood glucose levels forms the corner stone to prevent this dreaded complication.