Clinico-laboratory characteristics of diabetic keto acidosis in adults in a tertiary hospital in Saudi Arabia.

OBJECTIVE The present study is undertaken to evaluate the magnitude of DKA in Saudi population with specific emphasis on clinical laboratory characteristics over 20 years. MATERIAL AND METHODS A prospective analysis of hospital records of 240 episodes of DKA requiring inpatient admission from December 1985 to December 2005 in adult patients in a tertiary hospital was performed. Besides the demographic data of the patients, the clinico-laboratory parameters relevant to the diabetes and DKA status were thoroughly reviewed. RESULTS 150 males and 90 females were admitted with DKA with a mean age of 21.77 +/- 7.2 years. 16.6% (n=40) were diagnosed to have DM for the first time and others had a mean duration of DM of 5.02 +/- 4.88 years with an average daily insulin requirement being 45.09 +/- 23.9 units. 80.4% of the DKA episodes occurred in intermediate, secondary school and University level students. The commonest precipitating factors were missed insulin doses (51.2%) and respiratory tract infections (22.5%). The mean duration of stay in the hospital was 6.56 +/- 3.4 days and there were no deaths reported because of DKA. The mean blood sugar on presentation was 23.49 +/- 8.3 mmol/L whereas the mean pH and bicarbonate levels on presentation were 7.21 +/- 0.1 and 14.7 +/- 4.3 meq/L respectively. Blood pH was found to be significantly lower in female patients. Among patients below 20 years of age, females have significantly lower bicarbonate levels (11.7 +/- 6.2). Among patients above 20 years of age females had significantly longer duration of diabetes (8.86 +/- 8.36 years; p < 0.04). CONCLUSIONS By providing intensive education and increasing the awareness of DKA, a major reduction in morbidity and hospitalizations due to DKA may be expected.