بررسي فراواني علل زمينه ساز كتواسيدوز ديابتي ، عوارض و مرگ ومير ناشي از آن در نوجوانان و بزرگسالان

STUDY OF PREDISPOSING FACTORS, COMPLICATIONS AND MORTALITY OF DIABETIC KETOACIDOSIS IN TEENS AND ADULTS

The goal of this study was detection of common predisposing factors for diabetic ketoacidosis, which can be a guide for prevention. Also to know, complications and rate of mortality which can be a guide to know difficulties in treatment. This study was descriptive and sampling was in convennience method. About 50 patients were studied in Firooz Abadi Hospital during 1993-1998. Analysis of informations was with Chi-Square (X2-test) method. Common etiology was related to using drugs 52%, infection 26%, unknown 12% and unawarness of disease 10%. Complication were hyperkalemia 24%, hyperkalemia I 1%, resistance to insulin 4%, cardiac complications 20%, GI bleeding 8%, hypoglycemia 8%, renal failure 6%, adult respiratory distress syndrom (ARDS) 2% and disseminated intravascular coagulations (DIC) 6%. Other complications were rare. Mortality was 18% and was significant in older age (P = 0.01), in septicemia and pneumonia as the etiologies of the condition (P = 0.002, P = 0.003 respectively) and in some types of complications (like cardiac complications, DIC, ARDS, renal failure) and also in multiple complications. Therefore most common predisposing factor for diabetic ketoacidosis is incorrect use of drug, specialy discontinuing insulin. Most common complications is hypokalemia and hyperkalemia and cardiac complications. In some complications like cardiac, DIC, ARDS and renal failure, mortality were significant.