Authors: Sow Djiby, Diedhiou Demba, Dieng Mouhamed, Djiba Boundia, Ndour Michel AssaneDiallo Ibrahima Mané, Fall NdiougaSall Ibrahima, Gadji Fatou Kiné, Sarr Anna, Ndour Mbaye Maimouna.
Introduction: Diabetes is a public health problem, exposing patients to serious complications including ketoacidosis. The aim of this study was to describe the epidemiological, therapeutic and evolutionary aspects of diabetic ketoacidosis at the Abass ndao hospital in Dakar.
Patients and Methods: This was a cross-sectional, descriptive study conducted from January 01, 2016 to December 31, 2016. It focused on diabetic patients hospitalized for diabetic ketoacidosis. A standard questionnaire was drawn up to serve as the basis for data collection.
Results: One hundred and forty-three (143) cases of ketoacidosis were reported, representing a frequency of 18.94%. The mean age of patients was 46.52 years, with extremes of 15 and 87 years. The age groups [41-50] and [61-70] were the most represented with 19.6%. The female gender was more represented with 79 women (55.2%) with a sex ratio (f/h) equal to 0.81 Housewives were the most represented with 26.57%. Patients were predominantly from the Dakar region, with 133 cases (93%). Type 2 diabetes was predominantly represented with 66.4%. Diabetes had been evolving for less than 5 years in 60% of patients. Hypertension was present in 56 of our patients (39.16%). The average hospital stay was 18.46 days. Twenty-four patients (9.79%) were seen after 15 days. The most frequent reasons for hospitalization were polyuria-polydipsia with 54 cases or 37.76%, followed by dyspnea with 40 cases or 27.97%. Diabetic precoma was noted in 27 cases (9%). Twenty patients presented with fever (13.98%). An infectious factor of diabetic imbalance was noted in 73 patients (51.04%), and 34 patients (46.57%) had a respiratory infection. Diet deviations were noted in 20 patients (13.98%). MI was noted in 7 patients (46.66%). Hyperleukocytosis was found in 64 patients (44.75%), and CRP was elevated in 100 patients (74.62%). Mean capillary blood glucose was 3.3942 g/l. Ketonuria was greater than or equal to 2x in 143 patients (100%). Renal function was impaired in 57.34% of cases. Mean kalemia was 4.33meq/l, with extremes of 0.5 and 7meq/l, and hypokalemia was present in 30.06% of cases. Hyponatremia was found in 22.81%. Cardiac electrical disturbances were noted in 43 patients, or 30.06% of cases, revealing ischemic heart disease in 7 patients. The average length of stay was 8.43 days, with extremes of 1 and 42 days. There were 30 deaths (20.97%).
Conclusion: Diabetic ketoacidosis is a serious complication. It requires appropriate management and therapeutic education of patients.
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