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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2019; 02(01): 1-3
DOI: 10.4103/jdep.jdep_12_18
Original Article

Clinical profiles and precipitating factors for diabetic ketoacidosis at a tertiary center in Dubai, United Arab Emirates

Saira Abbas
Department of Internal Medicine, Diabetology Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
,
Zufana Nazir
Department of Internal Medicine, Diabetology Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
,
Touseef Azhar
Department of Internal Medicine, Diabetology Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
,
Abeer Alhaj
Department of Internal Medicine, Diabetology Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
,
Khadija Hafidh
Department of Internal Medicine, Diabetology Unit, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Objectives: Our aim was to assess the clinical profiles and determine the precipitating factors for diabetic ketoacidosis (DKA) in adult patients admitted to a tertiary care center in United Arab Emirates (UAE). Materials and Methods: We conducted a retrospective analysis of all patients admitted with DKA at a tertiary care hospital in UAE during June 2014–December 2017. Variables recorded included gender, type of diabetes, and HbA1c on presentation and identified precipitating factors. Results: Data from a total of 255 patients with DKA were analyzed. One hundred and fifty-seven of these patients had type 1 diabetes (61.6%) whereas 69 patients were diagnosed with type 2 diabetes mellitus (T2DM) (27.1%), and 22 patients could not be classified as type 1 or type 2. A small number of patients (2.7%) were found to have secondary diabetes as their DKA was precipitated by acute pancreatitis. Around 12% of cases occurred in the setting of newly diagnosed diabetes. The most common precipitating factor for DKA was noncompliance to treatment (31.4%), followed by infections (22.7%). Pancreatitis was another important precipitating factor which accounted for 6.3% of the cases. Conclusions: DKA is not limited to patients with T1DM, and there seems to be a steady increase in its occurrence in patients with T2DM. Noncompliance to therapy is a major precipitating factor which needs to be addressed by offering better education programs to prevent hospitalization of these cases.

Keywords

Diabetes - diabetic ketoacidosis - hospitalizations - pancreatitis - precipitating factors - type 1 diabetes - type 2 diabetes

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 10. November 2018

Angenommen: 19. April 2019

Artikel online veröffentlicht:
08. Juni 2022

© 2019. Gulf Association of Endocrinology and Diabetes (GAED). All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care 2009;32:1335-43.
  • 2 Vellanki P, Umpierrez GE. Increasing hospitalizations for DKA: A need for prevention programs. Diabetes Care 2018;41:1839-41.
  • 3 Umpierrez GE, Smiley D, Kitabchi AE. Narrative review: Ketosis-prone type 2 diabetes mellitus. Ann Intern Med 2006;144:350-7.
  • 4 International Diabetes Federation IDF Diabetes Atlas. 8th ed. Brussels, Belgium: International Diabetes Federation; 2017.
  • 5 Benoit SR, Zhang Y, Geiss LS, Gregg EW, Albright A. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality – United States, 2000-2014. MMWR Morb Mortal Wkly Rep 2018;67:362-5.
  • 6 Zhong VW, Juhaeri J, Mayer-Davis EJ. Trends in hospital admission for diabetic ketoacidosis in adults with type 1 and type 2 diabetes in England, 1998-2013: A retrospective cohort study. Diabetes Care 2018;41:1870-7.
  • 7 Savage MW, Dhatariya KK, Kilvert A, Rayman G, Rees JA, Courtney CH, et al. Joint British diabetes societies guideline for the management of diabetic ketoacidosis. Diabet Med 2011;28:508-15.
  • 8 Nyenwe EA, Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism 2016;65:507-21.
  • 9 Almalki MH, Buhary BM, Khan SA, Almaghamsi A, Alshahrani F. Clinical and biochemical characteristics of diabetes ketoacidosis in a tertiary hospital in Riyadh. Clin Med Insights Endocrinol Diabetes 2016;9:7-11.
  • 10 Al-Rubeaan KA, Aftab SA, Alotaibi MS, Alghamdi AA, Rafiullah MR. Clinico-laboratory characteristics of diabetic keto acidosis in adults in a tertiary hospital in Saudi Arabia. Eur Rev Med Pharmacol Sci 2011;15:1202-6.
  • 11 Nair S, Yadav D, Pitchumoni CS. Association of diabetic ketoacidosis and acute pancreatitis: Observations in 100 consecutive episodes of DKA. Am J Gastroenterol 2000;95:2795-800.
  • 12 Knight AH, Williams DN, Ellis G, Goldberg DM. Significance of hyperamylasaemia and abdominal pain in diabetic ketoacidosis. Br Med J 1973;3:128-31.
  • 13 Warshaw AL, Feller ER, Lee KH. On the cause of raised serum-amylase in diabetic ketoacidosis. Lancet 1977;1:929-31.
  • 14 Elliott J, Jacques RM, Kruger J, Campbell MJ, Amiel SA, Mansell P, et al. Substantial reductions in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced costs after structured education in adults with type 1 diabetes. Diabet Med 2014;31:847-53.