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- Title
Diabetic keto-acidosis in pancreatic diabetes – how is it different from DKA in type 1 or type 2 DM?
- Authors
Mondal, Sunetra; DasGupta, Riddhi; Lodh, Moushumi; Parida, Ashok; Haldar, Mandira; Ganguly, Arunangshu
- Abstract
Objective: There is scarcity of data on diabetic ketoacidosis (DKA) in patients with diabetes mellitus (DM) due to diseases of exocrine pancreas (T3DM). Methods: We did a retrospective record-review of patients admitted with DKA from 2017 to 2022. Clinical and biochemical characteristics were compared among DKA cases in type 1 DM (T1DM), type 2 DM (T2DM), and T3DM. Logistic regression was performed to find independent predictors of death and DKA complications. Results: Out of 107 cases, n = 79 were included (T1DM = 30, T2DM = 37, T3DM = 12). All cases of DKA in T3DM were of mild or moderate severity. The time to resolution of DKA was shortest for T3DM (p = 0.04). Death rates were similar in all groups but in T3DM, all deaths occurred after resolution of DKA. There was a precipitating factor for DKA in 11/12, 91.7% cases in T3DM group, most common being infections (58.3%) followed by glucocorticoid use (16.7%). T3DM cases had shorter duration of DM but higher CRP, procalcitonin, and qSOFA scores for infections precipitating DKA (pall < 0.03). CRP was an independent predictor for DKA-related complications (OR: 1.01, 1.001–1.01, p = 0.04). Conclusion: This is the largest single-center cohort of T3DM with new-onset DKA, suggesting severe infections and glucocorticoid usage as major precipitating factors, while clinical course and outcomes were distinctly different from T2DM and T1DM patients with DKA.
- Subjects
TYPE 1 diabetes; DISEASE duration; LOGISTIC regression analysis; DIABETIC acidosis; RETROSPECTIVE studies; DESCRIPTIVE statistics; INFECTION; CALCITONIN; EXOCRINE pancreatic insufficiency; LONGITUDINAL method; ODDS ratio; TYPE 2 diabetes; MEDICAL records; ACQUISITION of data; COMPARATIVE studies; DIABETES; GLUCOCORTICOIDS; C-reactive protein
- Publication
International Journal of Diabetes in Developing Countries, 2024, Vol 44, Issue 2, p278
- ISSN
0973-3930
- Publication type
Article
- DOI
10.1007/s13410-023-01244-x