DIABETIC KETOACIDOSIS;

Objectives: To observe the frequency, precipitating factors and outcome ofdiabetic ketoacidosis (DKA) in adults with established and newly diagnosed type 1 diabetesat a tertiary care hospital. Study Design: Retrospective study. Setting: Lahore GeneralHospital, Lahore. Period: From January 2013 through December 2015. Methods: Patients whowere admitted with a diagnosis of DKA. The clinical presentations, laboratory investigations,management, time of recovery and outcome were compared. Data were collected viaretrospective chart review. Results: A total of 202 patients were included who fulfilled the criteriaof DKA, of which 160 (79.2%) were less than 26 years of age with a male predominance of 156(97.5%). Out of all cases 72 (35.6%) had established Type 1 diabetes and 130 (64.4%) werenewly diagnosed. The most common presenting complaints in both groups were sepsis 105(52%). The comparison of clinical improvement and laboratory investigations between the twogroups showed that newly diagnosed Type 1 diabetes patients had lower pH, low bicarbonateand high BSR at presentation as compared to those with established type 1 diabetes. Thepatients with established diabetes improved earlier, required lesser duration of intravenousfluids and IV insulin was changed to subcutaneous in less time. Hospital stay of more than 7days was observed in patients with new diagnosis. Conclusion: It can be concluded from theabove data that earlier diagnosis of type 1 diabetes mellitus, appropriate treatment, regularscreening for complications and infections will result in less hospital admissions and betteroutcome.