Assessment of Treatment Pattern and Clinical Factors Associated with Diabetic Keto-acidosis admitted in the Department of General Medicine: A Cross-Sectional study at a Government Tertiary Care Teaching Hospital, Mandya, Karnataka, India

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus, commonly associated with type 1 diabetes but increasingly seen in patients with type 2 diabetes. It is characterized by hyperglycemia, ketosis, and metabolic acidosis. Prompt recognition of clinical features, identification of precipitating factors, and timely management are essential to reduce morbidity and mortality.  

Objectives: The aim of this study was to evaluate the clinical profile, precipitating factors, and prescribing patterns among patients with diabetic ketoacidosis admitted to the Department of General Medicine, MIMS Hospital, Mandya.

Methods and Methodology: This cross-sectional study was conducted over a period of six months in a tertiary care teaching hospital. A total of 83 in-patients diagnosed with DKA were included based on the inclusion criteria. Data were collected using a suitably designed case profile form, which documented demographic details, clinical presentations, precipitating factors, treatment patterns, and outcomes. Descriptive statistics and percentage analysis were used for data interpretation.

Results: Out of 83 patients, males (56.6%) were more commonly affected than females (43.3%). Type 2 diabetes mellitus (92.8%) was predominant compared to type 1 diabetes mellitus (7.2%). The majority of patients were in the 20–40 years age group (36.1%). The most common presenting symptoms were nausea and vomiting (63.8%), abdominal pain (43.3%), dehydration (30.1%), and altered sensorium (30.1%). Infections (73.4%) and non-compliance with treatment (66.2%) were the leading precipitating factors, with pneumonia (40.9%) and urinary tract infection (27.8%) being the most frequent infections. All patients received subcutaneous insulin and intravenous normal saline, while 85.5% were given intravenous insulin. Potassium supplementation was administered in 71% of cases, and sodium bicarbonate was reserved for severe cases (14.4%). The majority of patients (56.6%) were discharged within 5 days of hospitalization. 

Conclusion: The study highlights that DKA is more prevalent among patients with type 2 diabetes in this setting, with infection and poor treatment adherence being the major precipitating factors. Rational prescribing patterns, particularly the use of insulin and fluid therapy, were consistent with standard guidelines and contributed to favorable outcomes. Improved patient education, strict adherence to therapy, and effective infection control measures are essential to reduce the burden of DKA and improve patient outcomes in tertiary care hospitals.