Clinical characteristics and outcomes of diabetic ketoacidosis in Pakistani adults with Type 2 diabetes mellitus

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Abstract
Aims The aim of this study was to describe the clinical characteristics and outcomes of diabetic ketoacidosis (DKA) in Pakistani adult population with Type 2 diabetes mellitus. Methods We reviewed the medical records of all adult patients admitted with a diagnosis of DKA and Type 2 diabetes mellitus (DM) and followed their clinical course and outcome. Follow‐up data were obtained by chart review or telephone contact where necessary. Results Fifty‐seven patients fulfilled criteria for inclusion in the study. Their mean age was 48 ± 7 years. The mean body mass index was 25.5 ± 6.2 kg/m2. Forty‐nine had a prior history of Type 2 DM but DKA was the initial presentation in 14%. Nine were on no treatment, 40 were using oral hypoglycaemic agents and eight were on insulin. A history of prior DKA was noted in eight patients. Infections were the most common precipitating factor (63%). There were 12 deaths. Follow‐up after a period ranging between 12 and 43 months revealed that 30/45 patients remained on OHA without recurrence of DKA. Conclusion This report highlights the need for the growing recognition of DKA occurring in adults with Type 2 DM in the South Asian population. Mortality rates are unacceptably high but the majority of survivors remain insulin independent.