Peculiarities of the diabetic ketoacidosis course

Abstract

The aim of our study was to determine the prevalence and characteristics of some clinical symptoms and laboratory indicators as leading ones to determining the severity degree of diabetic ketoacidosis (DKA) and the variants of its clinical course. Materials and methods. 55 patients with acute critical decompensation of diabetes mellitus aged 9 to 65 years were examined. Clinical symptoms were studied, and biochemical changes in blood were determined using semi-automatic biochemistry photometer/analyzer Microlab 300 (USA, 2008). Results and discussions. Diabetic complaints and symptoms of intoxication were present in all patients in the DKA state. The most common variant of DKA was abdominal type, and the most severe encephalopathic and nephrotic types were. Encephalopathic variant was found in children and the elder persons, where the leading symptoms of severity were blood pH and hematocrit besides disorders of consciousness. The nephrotic variant was characterized by a long period of symptomatic development in comparison with other
variants such as hypotension, dyspnea and vomiting which were not expressed; according to laboratory indicators, there was blood glucose above 20 mmol/L, a low level of blood electrolytes, the disturbance of nitrogen metabolism. The cardiac variant was accompanied by changes in the ECG and initial hypokalemia. Abdominal type was the most typical, it was found in all age categories; dyspnoea, abdominal pain as pseudo-peritonitis, vomiting, general weakness prevailed in the clinic. Conclusions. Clinical and laboratory features of DKA have been established in different clinical variants and degrees of severity, which must be taken into account in the practical work of the physician in assessing abnormalities from the norm and diagnostic search, in further treatment.