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Original Research Article
Profiles of Diabetic
Ketoacidosis in Multiethnic Diabetic Population of
Malaysia
Atif Usman1,2*,
Syed Azhar Syed Sulaiman2, Amer Hayat Khan2,3
and Azreen Syazril Adnan3
1Department of Pharmacy
Practice, Faculty of Pharmaceutical Sciences, Government
College University Faisalabad, 38100 Faisalabad,
Pakistan, 2Discipline of Clinical Pharmacy,
School of Pharmaceutical Sciences, University of Science
Malaysia, 11800 Penang Island, Malaysia, 3Chronic
Kidney Disease (CKD) Resource Center, School of Medical
Sciences, University of Science Malaysia, 16150 Kota
Bharu, Kelantan, Malaysia
*For correspondence:
Email:
miyan.atif@gmail.com
Received: 3 March 2014
Revised accepted: 23 November 2014
Tropical Journal of Pharmaceutical Research,
January 2015;
14(1): 1 79-185
http://dx.doi.org/10.4314/tjpr.v14i1.25
Abstract
Purpose: To outline first-time
patient profiles of diabetic ketoacidosis (DKA) in the
absence of reported incidence and mortality rates of DKA
in Malaysian diabetic population.
Methods: A retrospective
cross-sectional study was designed and all medical
records of patients with a discharge note of DKA were
reviewed. Admissions from January 2009 to December 2011
were included. Data were analyzed in terms of
socio-demographic variables in order to provide
incidence and mortality rates. Medical history, as well
as physical and biochemical characteristics were
analyzed to report epidemiology of DKA patients.
Results: Out of a total of 207
admissions for DKA, 132 were selected for the present
study. Female (62.9 %), Malay ethnic (47.0 %) and the
elderly (45.1 years and above) contributed most to DKA
episodes. Type 2 diabetes mellitus (51.1 %) patients
were prone to develop DKA. Most patients experienced
mild to moderate episode of DKA by the time they sought
medical attention. Although, there was no significant
relationship between chronic co-morbidity and occurrence
of DKA, hypertension (54.5 %), dyslipidemia (43.0 %) and
cardiac disorders (35.6 %) were, however, the most
frequently observed co-morbidities. Non-adherence (43.2
%), sepsis (31.9 %) and respiratory tract infection
(12.2 %) were the most encountered precipitating factors
for DKA episode. Mortality rate was as high as 17.6 %.
Conclusion: With a higher incidence and
mortality rate of DKA in Malaysia, the patterns observed
in this study seem to be different from those of
developed nations. Further extended studies need to be
undertaken to elaborate regional and national patterns
of DKA.
Keywords: Incidence,
Mortality, Diabetic ketoacidosis, Diabetes,
Hypertension, Cardiac disorders, Dyslipidemia,
Comorbidity |