Gender Related Differences in Clinical Presentation and Outcomes of Diabetic Ketoacidosis: A Retrospective Study

Abstract

Abstract Background: Diabetic Ketoacidosis (DKA) is a well-known complication of Diabetes Mellitus (DM). Many studies have been conducted to observe the characteristics of DKA in both type 1 and type 2 DM. However, little is known about differences in the clinical features and outcomes of patients with DKA in relation to gender. In this study, we aimed to investigate whether there were any gender-related differences in the clinical presentation and outcomes of DKA patients. Methodology: We conducted this retrospective, descriptive study at the Aga Khan University Hospital (AKUH) Karachi, Pakistan, from July 2016 to July 2020. Data of patients above 16 years of age presented to the emergency department with DKA was reviewed. Information was collected regarding patient demographics, presenting symptoms, precipitating causes of DKA, vital signs, biochemical profiles, and outcomes at discharge. Results: Of 234 patients, 120 (51.3%) were males (mean age=46.8±16.6), and 114 (48.7%) were females (mean age=44±18.8). Our results showed that females had a higher chance of having previous episodes of DKA (13.4% vs. 4.2%) than males (p=0.047). There was a higher proportion of New Onset type 1 (24.2%) and New Onset type 2 (5.8%) Diabetes at presentation in male patients, as compared to female patients (14.0 and 1.8%, respectively). More male patients presented with severely altered mental status (24.2%) than female patients (13.2%). The higher biochemical markers in males included Hemoglobin, BUN, Creatinine, and serum osmolality, while Amylase was significantly higher in females. Finally, there were no significant differences in the outcomes between the two groups. Conclusion: As male patients in our population are more likely to present with New Onset type DM and are more likely to present with severe complications, preventive measures targeting male patients with risk factors for DM are paramount. Moreover, educational programs for both genders regarding complications and prevention are required. In order to form such plans, further studies at more centers need to be carried out so recommendations at a national level can be implemented.