2019, Vol. 2, Issue 2, Part C

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus (DM) that mostly affects type 1 diabetics and some type 2 diabetics. DKA is defined by hyperglycemia, ketoacidosis, and ketonuria. The real yearly incidence rate of DKA is difficult to determine, however, population-based studies have found rates ranging from 4.6 to 8 occurrences per 1,000 diabetic patients.

1.To find out the metabolic derangements occurring in DKA in 1st 48 hrs. of admission and to determine its relation with the duration of insulin infusion and hospital stay.

2.To find out the various precipitating factors.

3.To find the relation between various precipitating factors, biochemical abnormalities, mortality and morbidity of DKA.

Study Design: Hospital-based descriptive study.

Study area: The study was conducted in the Department of Paediatrics.

Study Period: 1 year.

Study population: All confirmed cases of DKA were admitted to the paediatric department.

Sample size: The study consisted of a total of 34 subjects.

Sampling Technique: Simple Random technique.

Inclusion criteria: All confirmed cases of DKA were admitted to the paediatric department.

5 ml of venous blood was drawn for estimation of urea, creatinine, and electrolytes namely sodium and potassium. Serum sodium and potassium were checked by the ion-selective electrode method protocol. Blood urea and Serum creatinine were evaluated automated chemistry analyser.

Arterial blood was drawn in the heparinized syringe for blood gas analysis. Acidosis, Chloride, bicarbonate and ionised calcium were measured by ABG machine, using the Ion Selective Electrode method. ABG was interpreted as the presence or absence of acidosis and the type of acidosis present.

Results: On applying the chi-square test, a significant reduction in the duration of insulin infusion was demonstrated in children whose electrolyte levels normalised at 24 hours. When the duration of insulin infusion in patients who had normal and abnormal electrolytes at 24 hours was compared, it was found that all patients who had normal electrolytes at 24 hours required insulin infusion less than 24 hours.

Conclusion: Diabetic patients must be educated about ketoacidosis symptoms and must adhere to medication to prevent DKA, early detection, and treatment, as well as consequences. Simple lifestyle changes, patient education on not missing insulin doses, particularly during illness, and giving patients with an adequate insulin regimen can significantly minimize DKA occurrence.