A prospective observational study on clinical profile, precipitating factors and management in patients presenting with diabetic ketoacidosis in a tertiary care hospital

AimTo assess clinical profile, precipitating factor and management in patient presenting with Diabetic ketoacidosis in a tertiary care hospital.In addition to that to know the effect of socioeconomic status, challenges encountered in management and finally to comapre the biochemical profile before and after treatment in the DKA patients. MethodologyIn this Prospective Observational study, a sample size of 40 patients with DKA and metting the inclusion criteria were considered for the study.Diagnosis of diabetic ketoacidosis was made according to the Blood glucose level more than 250mg/dl ,pH<7.3,Presence of blood ketone(0.6mmol/L)and Patients of age >15 admitted to adult ICU or General Medicine.Results Out of 40 patients admitted for diabetic ketoacidosis; 38 had type 2diabetes(95%) and 2(5%)were type 1 diabetes.the age of the patients ranged between 25 to 91 years with the mean age of 58.3818.45years.thegender distribution was 25(63%)males and 15(37%) female.16(40%)patients were in the lower middle class and 12(30%)patients were in upper middle class in socioeconomic classification.The most common clinical features at the time of presentation were Nausea /vomiting (63.33%),Pain abdomen(43%),dehydration(33.33%) and altered sensorium (30%).The commenest precipitating factor was infection in 21(52.5%)patients,Non compliance in 12(30%) followed by pancreatitis in 6(15%)patients.based on the severity of DKA 21(52.5%)patient had mild and 11(27.5%)patientshad moderate DKA.majority of the patients ie 16(40%) required more than 100units of insulin to clear blood ketone .11(27.5%)patient required more than 72 hrs of insulin therapy for clearance of blood ketone.thecomplication developed in DKA management were 15(37.5%)patientshowed hopokalemia and 3(7.5%) patients showed hypoglycemia.Conclusion Early recognition of diabetic ketoacidosis (DKA) through symptoms like nausea, vomiting, and dehydration leads to better outcomes.Common triggers include respiratory and urinary tract infections, poor compliance, and pancreatitis.Most patients were from the lower-middle socioeconomic class.Insulin therapy requires close monitoring to avoid hypokalemia and hypoglycemia, with treatment showing significant improvement.