Clinico-laboratory characteristics of diabetic keto acidosis in adults in a tertiary hospital in Saudi Arabia

K.A. AL-Rubeaan*, Syed Abdus Saboor Aftab^, Metib S. Alotaibi*, Ali A. AlGhamdi*, M.R.M. Rafiullah*

*University Diabetes Centre, King Abdulaziz University Hospital, King Saud University, Riyadh (Kingdom of Saudi Arabia)
^Division of Endocrinology, Department of Medicine, King Khalid University Hospital, King Saud University, Riyadh (Kingdom of Saudi Arabia)

---

• Internal Medicine

Objective: The present study is undertaken to evaluate the magnitude of DKA in Saudi population with specific emphasis on clinical laboratory characteristics over 20 years.

Material and Methods: A prospective analysis of hospital records of 240 episodes of DKA requiring inpatient admission from December 1985 to December 2005 in adult patients in a tertiary hospital was performed. Besides the demographic data of the patients, the clinico-laboratory parameters relevant to the diabetes and DKA status were thoroughly reviewed.

Results: 150 males and 90 females were admitted with DKA with a mean age of 21.77 ± 7.2 years. 16.6% (n=40) were diagnosed to have DM for the first time and others had a mean duration of DM of 5.02 ± 4.88 years with an average daily insulin requirement being 45.09 ± 23.9 units. 80.4% of the DKA episodes occurred in intermediate, secondary school and University level students. The commonest precipitating factors were missed insulin doses (51.2%) and respiratory tract infections (22.5%). The mean duration of stay in the hospital was 6.56 ± 3.4 days and there were no deaths reported because of DKA. The mean blood sugar on presentation was 23.49 ± 8.3 mmol/L whereas the mean pH and bicarbonate levels on presentation were 7.21 ± 0.1 and 14.7 ± 4.3 meq/L respectively. Blood pH was found to be significantly lower in female patients. Among patients below 20 years of age, females have significantly lower bicarbonate levels (11.7 ± 6.2). Among patients above 20 years of age females had significantly longer duration of diabetes (8.86 ± 8.36 years; p < 0.04).

Conclusions: By providing intensive education and increasing the awareness of DKA, a major reduction in morbidity and hospitalizations due to DKA may be expected.

Corresponding Author: Khalid A. Al-Rubeaan, MD; e-mail: krubean@ksu.edu.sa

Free PDF Download