Clinical Profile and Outcome of Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes: A Comparative Study

Abstract

Objectives: To Compare the Clinical and Biochemical Profile of DKA in Type 1 and Type 2 DM in terms of various complications and Mortality. Material and Methods: In this comparative study, a total of 95 patients admitted to tertiary care centres with DKA from October 2018 to December 2020, were enrolled. They were analysed for clinical profile and outcome in both groups. Results: Out of 95 patients, Type 1 DM was 18 (18.95%) and 77 (81.05%) were Type 2 DM. Among the clinical presentations, abdominal pain (61.11%) and breathlessness (55.55%) were common in Type 1 DM while breathlessness (40.25%) was the predominant presentation seen in Type 2 DM. There was no significant difference in the biochemical profile of patients in both groups with DKA. The mortality rate was higher in Type 2 DM (12.63%) than Type 1 DM (3.15%). Septicaemic shock (40%) was the most common cause of mortality and the next common was pneumonia in 33%. Severe acidosis, low Glasgow Coma Scale (GCS), high doses and longer duration of insulin therapy, higher acute physiology, and chronic health evaluation II (APACHE-II) score, and high serum osmolality had a bad outcome and were associated with high mortality. Conclusion: DKA is commonly observed in Type 2 DM also. Infection is the most common precipitating factor for DKA. Type 2 DM had the more severe presentation of DKA as compared to Type 1 DM with DKA. Increased APACHE-II, the requirement of insulin, and length of hospital stay are a predictor of mortality. However, GCS, APACHE-II score, and ABG parameters can predict outcomes in DKA.