PMID- 29781681
OWN - NLM
STAT- MEDLINE
DCOM- 20181023
LR  - 20181114
IS  - 2071-2936 (Electronic)
IS  - 2071-2928 (Print)
IS  - 2071-2928 (Linking)
VI  - 10
IP  - 1
DP  - 2018 Mar 22
TI  - The management of diabetic ketoacidosis at a rural regional hospital in 
      KwaZulu-Natal.
PG  - e1-e6
LID - 10.4102/phcfm.v10i1.1612 [doi]
LID - 1612
AB  - BACKGROUND:  Diabetic ketoacidosis (DKA) is a biochemical triad of 
      hyperglycaemia, ketoacidosis and ketonaemia and one of the potentially 
      life-threatening acute metabolic complications of diabetes mellitus. This study 
      aimed at describing the clinical profile of patients presenting with DKA to a 
      busy rural regional hospital in KwaZulu-Natal. METHODS:  A retrospective review 
      of clinical notes of patients presenting with DKA to the Emergency Department was 
      performed over a 10-month period. Data included patients' demographic profile, 
      clinical presentation, precipitating factors, comorbidities, biochemical profile, 
      length of hospital stay and outcome. RESULTS:  One hundred and five black South 
      African patients above the age of 12 years were included in the study. Sixty-four 
      (60.95%) patients had type 1 diabetes mellitus (T1DM) and 41 (39.05%) patients 
      had type 2 diabetes mellitus (T2DM). Patients with T2DM were significantly older 
      than those with T1DM (52.1 +/- 12.4 years vs. 24.4 +/- 9.5 years, p < 0.0001). The 
      acute precipitant was identified in 68 (64.76%) cases with the commonest 
      precipitant in T1DM patients being poor adherence to treatment, whereas in T2DM, 
      the most common precipitant was infection. Nausea and vomiting were the most 
      common presenting symptoms with the majority of patients presenting with 
      non-specific symptoms. Fifty-seven (54.29%) cases had pre-existing comorbidities, 
      with higher prevalence in T2DM than T1DM patients. Glycated haemoglobin was 
      severely elevated in the majority of patients. Patients remained hospitalised for 
      an average of 8.9 +/- 7.5 days. The mortality rate was 17.14%, and 12 of the 18 
      deaths occurred in patients with T2DM. CONCLUSION:  The prevalence of DKA was 
      higher in patients with T1DM and those with pre-existing comorbidities. The 
      mortality rate remains alarmingly high in older patients with T2DM.
FAU - Ndebele, Nontobeko F M
AU  - Ndebele NFM
AD  - School of Clinical Medicine, University of KwaZulu-Natal. naidoom@ukzn.ac.za.
FAU - Naidoo, Mergan
AU  - Naidoo M
LA  - eng
PT  - Journal Article
DEP - 20180322
PL  - South Africa
TA  - Afr J Prim Health Care Fam Med
JT  - African journal of primary health care & family medicine
JID - 101520860
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Child
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 1/complications/epidemiology
MH  - Diabetes Mellitus, Type 2/complications/epidemiology
MH  - Diabetic Ketoacidosis/epidemiology/*etiology/mortality
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Medication Adherence
MH  - Middle Aged
MH  - Prevalence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - South Africa/epidemiology
MH  - Young Adult
PMC - PMC5913763
OTO - NOTNLM
OT  - diabetic ketoacidosis
OT  - outcomes
OT  - rural setting
COIS- The authors declare that they have no financial or personal relationships which 
      may have inappropriately influenced them in writing this article.
EDAT- 2018/05/22 06:00
MHDA- 2018/10/24 06:00
PMCR- 2018/03/22
CRDT- 2018/05/22 06:00
PHST- 2017/08/18 00:00 [received]
PHST- 2017/12/12 00:00 [accepted]
PHST- 2017/11/30 00:00 [revised]
PHST- 2018/05/22 06:00 [entrez]
PHST- 2018/05/22 06:00 [pubmed]
PHST- 2018/10/24 06:00 [medline]
PHST- 2018/03/22 00:00 [pmc-release]
AID - PHCFM-10-1612 [pii]
AID - 10.4102/phcfm.v10i1.1612 [doi]
PST - epublish
SO  - Afr J Prim Health Care Fam Med. 2018 Mar 22;10(1):e1-e6. doi: 
      10.4102/phcfm.v10i1.1612.