Study of Diabetic Ketoacidosis with Special References to the Biochemical Prognostic Marker

Abstract

Background: Diabetes Mellitus is a clinically and genetically heterogeneous group of metabolic disorders that manifest in an abnormally high level of glucose in the blood. Diabetic Ketoacidosis (DKA) represent extremes in the spectrum of decompensated diabetes. The mortality in patients with Diabetic Ketoacidosis is rarely caused by a metabolic complication of hyperglycemia or metabolic acidosis and it is usually related to the underlying medical illness that precipitates metabolic compensation. The second most important contributor to the development of DKA is inadequate insulin treatment, commonly seen as a result of noncompliance, especially in the young population. Methods: The present study was conducted for period of 2 years. It is a hospital based prospective observational study of 60 Diabetic Ketoacidosis patients. The biochemical prognostic markers were studied. Results: The study was done for 60 patients diagnosed with Diabetic Ketoacidosis presented to the medicine department. The mean age was 55.44 years. So from the current study it was proved that, serum phosphorus and APACHE II score can be used for predicting the prognosis in the the DKA patients. The mean serum phosphate among the deceased patients (n = 8) was more as compared to the discharged patients (n = 52). Out of 60 patients, highest patients (n = 38) had infection (AFI, LRTI, pneumonia. UTI, sepsis pancreatitis, enterocolitis, AKI, viral fever) as their precipitating factors. Conclusion: APACHE II score and serum phosphorus is an important biochemical marker in the prognosis of DKA. APACHE II score is directly proportional to mortality index in DKA.