Clinical Profile and Outcome of Diabetic Ketoacidosis in a Tertiary Care Teaching Hospital of a Developing Country

Meghna Chawla; Tushar Deshpande; MK Behera

Objectives: Diabetic Ketoacidosis (DKA) is a dreaded complication and due to a paucity of studies on Paediatric DKA from India, we studied its clinical profile and outcome over the last 03 years.

Methods: A retrospective chart review was used to obtain demographics, clinical presentation and various laboratory parameters on presentation of DKA in children less than 12 years of age.

Results: See Tables 1–3.

Table 1 Demographic parameters of study cases (n=20)
	DKA in New–Onset DM (n=11)	DKA in Diagnosed DM (n=9)	All DKA cases (n=20)
Variables	Mean (95%CI of Mean), OR n (%)	Mean (95%CI of Mean), OR n (%)	Mean (95%CI of Mean), OR n (%)	P-value
Age (years)	8.5 (6.8–10.2)	9.2 (6.8–11.5)	8.8 (7.5–10.1)	0.616^NS
Age Groups (years)	5–10 years	7 (63.6)	4 (44.4)	11 (55.0)	0.653^NS
10–12 years	4 (36.4)	5 (55.6)	9 (45.0)
Male Sex	6 (54.5)	1 (11.1)	7 (35.0)	0.070^NS
Anthropometry	Height (cm)	122.6 (112.7–132.6)	121.2 (113.6–128.8)	122.0 (116.1–127.9)	0.810^NS
	Weight (kg)	20.3 (16.7–23.9)	19.2 (16.3–22.0)	19.8 (17.6–21.9)	0.597^NS
	BMI (kg/m²)	13.7 (11.2–16.1)	12.9 (12.3–13.6)	13.3 (12.1–14.6)	0.568^NS

Table 2 The clinical outcome of study cases (n=20)
Glycaemia	Blood Glucose (mg%)	542.4 (468.6–616.1)	537.4 (490.9–583.9)	540.1 (498.6–581.7)	0.906^NS
	HbA1C (%)	12.6 (11.7–13.6)	12.2 (11.3–13.1)	12.4 (11.8–13.0)	0.460^NS
Urine Ketones	Moderate	3 (27.3)	5 (55.6)	8 (40.0)	0.343^NS
	Severe	7 (63.6)	4 (44.4)	11 (55.0)
	Highly Severe	1 (9.1)	0	1 (5.0)
pH	7.15 (7.05–7.25)	7.19 (7.14–7.25)	7.17 (7.11–7.22)	0.390^NS
HCO3	9.0 (6.3–11.7)	10.5 (8.5–12.5)	9.7 (8.1–11.3)	0.358^NS
Sodium	140.1 (135.0–145.2)	137.8 (133.7–141.9)	139.0 (135.9–142.1)	0.450^NS
Potassium	4.2 (3.7–4.8)	4.7 (3.8–5.7)	4.5 (3.9–4.9)	0.292^NS
Chloride	105.4 (100.9–109.9)	106.4 (101.4–111.5)	105.8 (102.8–108.9)	0.720^NS
Time for resolution	31.6 (24.8–38.5)	18.4 (13.9–22.9)	25.7 (20.7–30.7)	0.003^**

Table 3 Associated complications
UTI	0	3 (33.3)	3 (15.0)	0.206^NS
Pneumonia	1 (9.1)	1 (9.1)	2 (10.0)
Cerebral edema	2 (18.2)	0	2 (10.0)
Other	0	1 (9.1)	1 (5.0)
^NS Statistically not significant

Conclusions: The mean age, sex and anthropometric parameters did not differ significantly. Laboratory parameters or the incidence of complications also did not differ significantly. However, the mean time of resolution is significantly higher in the new-onset group (P-value<0.01).

ESPE Abstracts

P3-P109