Usman, Atif
(2013)
Diabetic Ketoacidosis: Evaluation Of
Therapeutic Outcomes, And Knowledge,
Attitude And Practices Of Physicians
And Pharmacists In Hospital Pulau
Pinang.
Masters thesis, Universiti Sains Malaysia.
Abstract
Incidence of Diabetes Mellitus (DM) and its associated acute co-morbidities is
increasing. However, there is no Diabetic Ketoacidosis (DKA) treatment protocol in
Malaysia at this point. There is no baseline data available for DKA in Malaysia as well.
This study aims to record incidence rate of DKA and its treatment outcomes in
Malaysian population. It is also intended to get an insight of knowledge, attitude and
practices of healthcare professionals that are directly involved in management of DM
and DKA. For first part, the study was done retrospectively at Hospital Pulau Pinang
(HPP). DKA patient profiles were recorded by using universal sampling technique based
on inclusion criteria and further analyzed using Statistical Package for Social Sciences
(SPSS)® version 16. Of total 132 DKA patients, mean age of patients was 47.7 ± 16.3
years while most admissions were attributed to Malay patients (47%). DKA was more
prevalent in T2DM (51.5%) patients followed by hypertension (54.5%) and
dyslipidemia (43.0%). Most patients (61.4%) registered complaint of nausea and
vomiting, and were accompanied with sepsis (31.9%) whereas attending physicians
observed 83.3% patients to be dehydrated. Moreover, with mean blood glucose level at
30.4 ± 13.3 mmol · L-1, arterial pH at 7.15 ± 0.16, arterial bicarbonate at 9.7 ± 5.5 mmol
· L-1 and ketones at 4.6 ± 1.7 mmol · L-1, chief DKA biochemical profiles rendered
patients to be experiencing moderate episode of DKA, on average. It was also observed
that newly diagnosed diabetes mellitus (NDDM) patients, deceased patients and ICU
referred patients had more severe event of DKA than the rest of patients.
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