ANALYSIS OF DIABETIC KETOACIDOSIS CASES IN HOSPITAL TELUK INTAN IN 2023

Abstract

INTRODUCTION
There is an increase in the incidence of diabetes mellitus (DM) in Malaysia and worldwide. Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes and is even the first presentation of diabetes in some patients.

METHODOLOGY
This study aims to evaluate the incidence and outcome of DKA patients in a district hospital Hospital Teluk Intan (HTI) in 2023. This is a retrospective audit which included every patient who was admitted for DKA in HTI from January 2023 until December 2023. The data was collected from clinical notes and electronic medical records.

RESULT
Forty subjects were included in this audit which comprised 20 males and 20 females. The median age of the study population was 53.5 years and most patients were Malay (82.5%), followed by Indian (10%) and Chinese (7.5%). Most of them had type 2 DM [34 (87.5%)] whereas the rest had type 1 DM [4 (10.3%)] and newly diagnosed DM [1 (2.6%)]. The most common causes of DKA were sepsis [22 (55%)] and non-compliance to medications [16 (40%)]. The mean HbA1c during admission was 13.9% and the median length of stay was 5.5 days. Twelve patients (30%) had severe DKA and 17 patients (42.5%) required ICU/HDU admission in which 2 patients (5%) required intubation. About 2/3 of patients [24 (60%)] had DKA resolution within 24 hours of admission and most patients were discharged home [37 (92.5%)]. The low mortality rate could be due to early diagnosis and high admission to ICU/HDU.

CONCLUSION
The high number of DKA cases is mainly caused by sepsis and non-compliance to medication, which are critical areas to address to prevent DKA occurrences. While infections may be inevitable, it is essential to counsel diabetes patients on the importance of strict adherence to their medications to avoid serious complications.