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South African Family Practice

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An Identification of the Risk Factors Implicated in Diabetic Ketoacidosis (DKA)

S Mudly, V Rambiritch, L Mayet

Abstract




Background:
Despite improvements in therapy and disease monitoring, diabetic ketoacidosis (DKA) remains a potentially fatal consequence. This retrospective study was undertaken to establish and identify those risk factors that are responsible for the onset of DKA.

Methods:
The medical records of 77 patients from Addington Hospital, who satisfied the criteria for inclusion into the study of DKA, were reviewed (60 type 1 diabetes mellitus (DM) patients and 17 type 2 DM patients).

Results:
More juveniles were admitted for multiple DKA episodes (65%) than non-juveniles (35%). DKA occurred in 23% of newly diagnosed type 1 DM on first presentation. Infection was present in 40% of type 1 DM patients with single DKA episodes and in 45% of type 1 DM patients with multiple DKA episodes. A total of 23.2% of all admissions for single DKA involved non-compliance of medication usage and was implicated in 32% of multiple DKA episodes Family and/or school problems presented in 7% of single DKA episodes and 4% in multiple DKA episodes. In the present study, the overall mortality rate was 2.5% (n=2).

Conclusion:
This study showed that the most important risk factors implicated in DKA were infection, non-compliance and newly diagnosed diabetes, followed by family and/or school problems, low socio-economic status and omission of insulin.


South African Family Practice Vol. 49 (10) 2007: pp. 15a-15b



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