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Patil, Chetan
- Study of Diabetic Ketoacidosis with Special References to the Biochemical Prognostic Marker
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Authors
Affiliations
1 Former PG Resident, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Associate Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
1 Former PG Resident, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Associate Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Professor, Department of Internal Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
Source
MVP Journal of Medical Sciences, Vol 8, No 1 (2021), Pagination: 124-131Abstract
Background: Diabetes Mellitus is a clinically and genetically heterogeneous group of metabolic disorders that manifest in an abnormally high level of glucose in the blood. Diabetic Ketoacidosis (DKA) represent extremes in the spectrum of decompensated diabetes. The mortality in patients with Diabetic Ketoacidosis is rarely caused by a metabolic complication of hyperglycemia or metabolic acidosis and it is usually related to the underlying medical illness that precipitates metabolic compensation. The second most important contributor to the development of DKA is inadequate insulin treatment, commonly seen as a result of noncompliance, especially in the young population. Methods: The present study was conducted for period of 2 years. It is a hospital based prospective observational study of 60 Diabetic Ketoacidosis patients. The biochemical prognostic markers were studied. Results: The study was done for 60 patients diagnosed with Diabetic Ketoacidosis presented to the medicine department. The mean age was 55.44 years. So from the current study it was proved that, serum phosphorus and APACHE II score can be used for predicting the prognosis in the the DKA patients. The mean serum phosphate among the deceased patients (n = 8) was more as compared to the discharged patients (n = 52). Out of 60 patients, highest patients (n = 38) had infection (AFI, LRTI, pneumonia. UTI, sepsis pancreatitis, enterocolitis, AKI, viral fever) as their precipitating factors. Conclusion: APACHE II score and serum phosphorus is an important biochemical marker in the prognosis of DKA. APACHE II score is directly proportional to mortality index in DKA.Keywords
APACHE II, Diabetic Ketoacidosis, Glasgow Coma Scale, Serum PhosphateFull Text
References
- Delaney MF, Zisman A, Kettyle WM. Diabetic Ketoacidosis and hyperglycemic hyperosmolar nonketotic syndrome. Endocrinol Metab Clin North Am. 2000; 29:683–705 https://doi.org/10.1016/S0889-8529(05)70159-6
- Gosmanov AR. et al. Hyperglycemic Crises: Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS). NCBI. 2018.
- Oldenhuis CN1, Oosting SF, Gietema JA, de Vries EG. Prognostic versus predictive value of biomarkers in oncology. Eur J Cancer. 2008; 44(7):946–53. PMid: 18396036. https://doi.org/10.1016/j.ejca.2008.03.006
- Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE I1: a severity of disease classification system. Crit Care Med 1985; 13:818–29. PMid: 3928249. https://doi.org/10.1097/00003246-198510000-00009
- Zimmerman JE. APACHE III study design: Analytic plan for evaluation of severity and outcome. Crit Care Med. 1989; 17:S169–221. PMid: 2591237. https://doi.org/10.1097/00003246-198912001-00002
- Matoo VK, et al. Clinical profile and treatment outcome of Diabetic Ketoacidosis. Journal of the Association of Physicians of India. 1991; 39(5):379–81.
- Agarwal A, Ambul Y, Manish G. Prognostic factors in patients hospitalized with Diabetic Ketoacidosis. Endocrinol Metab (Seouli). 2016 Sep; 31(3):1–8. PMid: 27586452 PMCid: PMC5053055. https://doi.org/10.3803/ EnM.2016.31.3.424
- Bedaso A. et al. Diabetic Ketoacidosis among adult patients with Diabetes Mellitus admitted to emergency unit of Hawassa university comprehensive specialized hospital. BMC. 2019; 12. PMid: 30871605 PMCid: PMC6419397. https://doi. org/10.1186/s13104-019-4186-3
- Kitabchi AE, Umpierrez GE, Murphy MB, Kreisberg RA. Hyperglycemic crises in adult patients with diabetes: A consensus statement from the American Diabetes Association. Diabetes Care. 2006; 29:2739–48. [PubMed]. PMid: 17130218. https://doi.org/10.2337/dc06-9916
- Barski L, Nevzorov R, Harman-Boehm I, Jotkowitz A, Rabaev E, Zektser M, et al. Comparison of Diabetic Ketoacidosis in patients with type-1 and type-2 Diabetes Mellitus. Am J Med Sci. 2013; 345:326–30. [PubMed]. PMid: 23377164. https://doi.org/10.1097/MAJ.0b013e31827424ab
- Efstathiou SP, Tsiakou AG, Tsioulos DI, Zacharos ID, Mitromaras AG, Mastorantonakis SE, et al. A mortality prediction model in Diabetic Ketoacidosis. Clinical Endocrinology. 2002; 57(5):595–601. [PubMed] [Google Scholar]. PMid: 12390332. https://doi.org/10.1046/j.1365-2265.2002.01636.x
- Mahesh MG, Shivaswamy RP, Chandra BS, Syed S. The study of different clinical pattern of Diabetic Ketoacidosis and common precipitating events and independent mortality factors. J Clin Diagn Res. 2017; 11(4):OC42–6. PMid: 28571190 PMCid: PMC5449836. https://doi.org/10.7860/ JCDR/2017/25347.9760
- Ahuja W, Kumar N, Kumar S, Rizwan A. Precipitating risk factors, clinical presentation, and outcome of Diabetic Ketoacidosis in patients with type 1 diabetes. Cureus. 2019; 11(5). PMid: 31372327 PMCid: PMC6669022. https://doi. org/10.7759/cureus.4789
- Hartalkar A, Hartalkar S, Peshwe K, Nath B. Profile of precipitating factors in Diabetic Ketoacidosis: Data from a rural teaching hospital. Journal of Preventive Medicine and Holistic Health. 2015 Jul-Dec; 1(2):92–5. https://doi. org/10.5958/2394-6776.2016.00001.1
- Rahim M, Uddin K, Zaman S, Musa A, Rahman M, Hossain M et al. Clinical spectrum and management of Diabetic Ketoacidosis: Experience in a tertiary care hospital. Birdem Med J 2011; 1(1):15–20. https://doi.org/10.3329/birdem. v1i1.12380
- Otieno CF, Kayima JK, Mbugua PK, Amayo AA, Mcligeyo SO. Prognostic factors in patients hospitalised with Diabetic Ketoacidosis at Kenyatta National Hospital, Nairobi. East Afr Med J. 2010; 87:66–73. [PubMed]. https:// doi.org/10.4314/eamj.v87i2.60600
- Rahim MA. et al. Clinical characteristics and outcome of Diabetic Ketoacidosis: Experience at BIRDEM, Dhaka, Bangladesh. Bangladesh Crit Care J. 2015 Sep; 3(2):53–6. https://doi.org/10.3329/bccj.v3i2.25110
- Kebler R, McDonald FD. Dynamic changes in serum phosphorus levels in Diabetic Ketoacidosis. 1985 Nov; 79(5):571–6. https://doi.org/10.1016/0002- 9343(85)90053-1
- Ellemann K, Soerensen JN, Pedersen L, Edsberg B, Andersen OO. Epidemiology and treatment of Diabetic Ketoacidosis in a community population. Diabetes Care. 1984; 7:528–32. [PubMed]. PMid: 6439530. https://doi. org/10.2337/diacare.7.6.528
- Freire AX, Umpierrez GE, Afessa B, Latif KA, Bridges L, Kitabchi AE. Predictors of intensive care unit and hospital length of stay in Diabetic Ketoacidosis. J Crit Care. 2002; 17(4):207–11. PMid: 12501147. https://doi.org/10.1053/ jcrc.2002.36755
- A Study to Evaluate Correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome
Abstract Views :158 |
PDF Views:80
Authors
Affiliations
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
1 Former PG Resident, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
2 Associate Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
3 Professor, Department of Medicine, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, India ., IN
Source
MVP Journal of Medical Sciences, Vol 9, No 1 (2022), Pagination: 1 - 8Abstract
Incidence of diabetes is increasing substantially worldwide. Cardiovascular disease is most prevalent cause of mortality and morbidity in diabetic populations. Cardiovascular risk factor including obesity, hypertension, dyslipidemia are common in patients with diabetes mellitus particularly with those of type 2 diabetes. Atherosclerosis has been described as an inflammatory disease. Aim: Study to evaluate correlation of C-Reactive Protein and Glycosylated Haemoglobin in Patients of Diabetes Suffering from Acute Coronary Syndrome. Material and Methods: A descriptive study after satisfying criteria was conducted in 115 patients in medicine department of a medical college and tertiary care hospital over a period of two years that included patients of diabetes suffering from acute coronary syndrome in the age group of 30 to 70 years. Evaluation and correlation was done by clinical profile. Results: Majority of patients were elderly age group of male of 51 to 60 yrs having mean BMI of 24 kg/m2 . CRP level of >3 mg/dl was found in 77.39% and majority of patients had HbA1C >7%. CRP and HbA1C were significantly correlated (p<0.05). Majority of patients with elevated CRP were found in with killip class I. But CRP and killip classification were not significantly correlated in our study. Conclusion: Elevated C Reactive Protein and Glycosylated Haemoglobin are better correlated as poor prognostic marker for cardiovascular event in patients of diabetes suffering from acute coronary syndrome.Keywords
CAD, Cholesterol, CRP, Diabetes, HbA1cFull Text
References
- Wild S, Roglic G, Green A. Global prevalence of diabetes: Estimate for the year 2000 and projection for 2030 Diabetes care. 2004. https://doi.org/10.2337/diacare.27.10.2569-a
- Matheus AS, Tannus LR, Cobasra RA. Impact of diabetes on cardiovascular disease: An update. Int J Hypertens. 2013: 653789. PMid: 23533715 PMCid: PMC3603160.https://doi.org/10.1155/2013/653789
- Yudkin JS, Blauth C, Drury P. Prevention and management of cardiovascular disease in patients with diabetes mellitus: An evidence base. Diabetic Med. 1996; 13: S101–21.
- Ross R. Atherosclerosis - an inflammatory disease. N Engl J Med. 1999; 340: 115–26. PMid: 9887164. https://doi.org/10.1056/NEJM199901143400207
- Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol. 1967; 20(4): 457–64. https://doi.org/10.1016/0002-9149(67)90023-9
- Nyandak T, Gogna A, Bansal S. High sensitive C-Reactive Protein (hs-CRP) and its correlation with Angiographic Severity of Coronary Artery Disease (CAD). JIACM. 2007; 8(3): 217–21.
- Khaw KT, Wareham N, Bingham S. Jet powered engines. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: The European prospective investigation into cancer in Norfolk. Ann Intern Med. 2004; 141: 413–20. PMid: 15381514. https://doi.org/10.7326/0003-4819-141-6-200409210-00006
- Sasidharan A, Krishnamurthy A, Tagore S. C-Reactive Protein and glycemic control in adults with type 2 diabetes mellitus. Journal of Medicine, Radiology, Pathology and Surgery. 2016; 2: 10–3. https://doi.org/10.15713/ins.jmrps.56
- Abdul Razzaq MK, Rasheed JI, Mohmmad HS. The value of admission glucose and glycosylated hemoglobin in patients with acute coronary syndrome. The Iraqi Postgraduate Medical Journal. 2013; 12(1).
- Babu LE, Joshi A. Correlation of high-sensitivity C-Reactive Protein with blood sugar level in patients with Type 2 diabetes. National Journal of Physiology, Pharmacy and Pharmacology. 2018; 8(7): 37–41. https://doi.org/10.5455/ njppp.2018.8.0726805082017
- Singh S, Bansal M, Rani K. Prognostic significance of Glycosylated Hemoglobin in Nondiabetic Patients in Acute Coronary Syndrome. Heart India. 2016; 4(1): 17-22.
- Pasupathi P, Raoa YY, Farook J. The combinational effect of cardiac and biochemical markers in diabetic patients with cardiovascular disease. Int J Cur Bio Med Sci. 2011; 1(2): 30–4.
- Mani VE, John M, Rajneesh Calton. Impact of HbA1c on Acute Cardiac States. (Accessed [Last received on: 2009 Dec 03; Last revised on 2010 Feb 03; Last accepted on 2010 Feb 05]). http://www.japi.org/ june_2011/article_03.pdf
- Selvin E, Marinopoulos S, Berkenblit G. Meta-analysis: Glycosylated Haemoglobin and cardiovascular disease in diabetes mellitus. 2004; 141: 421–31. PMid: 15381515. https://doi.org/10.7326/0003-4819-141-6-20040921000007
- Malmberg K, Norhammar A, Wedel H. Glycometabolic state at admission: Important risk marker of mortality in conventionally treated patients with diabetes mellitus and acute myocardial infarction: Long term results from the Diabetes and Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) study. Circulation. 1999; 99: 2626 –32. PMid: 10338454. https://doi.org/10.1161/01.CIR.99.20.2626 .
- Basar GS. CAGE - Study of C-Reactive Protein and Glycosylated Haemoglobin in adult type 2 diabetes
- mellitus. 3rd World Congress on Diabetes and Metabolism. 2010; 32.
- King DE, Mainous AG3rd, Buchanan TA, Pearson WS. C-Reactive Protein and glycemic control in adults with diabetes. Diabetes Care. 2003; 26(5): 1535–9. PMid: 12716818. https://doi.org/10.2337/diacare.26.5.1535 .