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Precipitating Factors and Laboratory Investigations at the Time of Presentation in Patients with Diabetic Ketoacidosis

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新疆医科大学硕士研究生学位论文导师评阅表

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Background:Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes mellitus. The purpose of this study has to measure the precipitating factors and the related laboratory investigations at the time of presentation when the patients with DKA come to the teaching hospital of xmu.
  Patients and Methods: There were 134 diabetes mellitus patients, hospitalized with DKA from 2nd January 2011 to 23rd October 2013. We get the patient data by seeing the medical reports in Endocrinology and Diabetes Department. Then we divided patients in to 3 groups which were on the basis of their based on the sharpness of the disease and the precipitating factors for disease sharpness were recognized by analyzing these 3groups.
  Results: In 134 DKA patients, 61 (45.52%) were mild DKA;mean age 40.29±17.39, 63 (47.01%) were moderate DKA, mean age 37.51 ±16.38 and 10 (7.46%) were severe DKA, mean age 31.5 ± 12.76. Discontinuation or inadequate insulin therapy was common precipitating factor in the three groups (32.78%, 38.09%and 50%) but the second common precipitating factor in mild DKA was infection (27.87%), in moderate DKA was new onset diabetes (28.57%) and in severe DKA infection and new onset diabetes were in same ratio (20%each). The laboratory test results showed that the plasma glucose, serum potassium, serum sodium, serum creatinine, blood urea and blood WBC were increased in severity from mild to moderate and to severe.
  Conclusion: In this study, discontinuation or inadequate insulin therapy was more common precipitating factor of DKA, followed by infection and new onset diabetes. The abnormalities of laboratory tests occurred due to the hyperglycemia and metabolic acidosis. Patient knowledge related to the importance of insulin use, the drugs have to be there for treating the temperature and as well the underlying infection and inflammation, also the disease awareness is very helpful in prevention of DKA.

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