Izvorni znanstveni članak
PRECIPITATING FACTORS AND CLINICAL FEATURES OF DIABETIC KETOACIDOSIS
NINO MATAS
; Odjel za opću internu, Opća bolnica Dubrovnik, Dubrovnik, Hrvatska
ANJA BARAČ NEKIĆ
orcid.org/0000-0003-2672-8529
; Zavod za endokrinologiju, Klinički bolnički centar Zagreb, Zagreb, Hrvatska
SANJA MLINARIĆ VRBICA
orcid.org/0000-0003-2575-7918
; Odjel za opću internu, Opća bolnica Dubrovnik, Dubrovnik, Hrvatska
ANELA NOVAK
orcid.org/0000-0003-2575-7918
; Zavod za endokrinologiju, dijabetologiju i bolesti metabolizma, Klinički bolnički centar Split, Split, Hrvatska; Medicinski fakultet Split, Sveučilište u Splitu, Split, Hrvatska
TATJANA BAČUN
; Medicinski fakultet Osijek, Sveučilište u Osijeku, Osijek, Hrvatska; Zavod za endokrinologiju, Klinički bolnički centar Osijek, Osijek, Hrvatska
IVAN FELDI
orcid.org/0000-0001-6310-2205
; Odjel za internu medicinu, Opća bolnica Našice, Našice, Hrvatska
SVETOLIK SPASIĆ
orcid.org/0000-0002-5352-8998
; Institut za patološku fiziologiju Ljubodrag Buba Mihailović, Medicinski fakultet, Beograd, Republika Srbija
ANTONELA ČOLIĆ
orcid.org/0009-0007-0581-1071
; Zavod za hitnu medicinu Dubrovačko-neretvanske županije, Orebić, Hrvatska
FRAN VRANDEČIĆ
; Dom zdravlja Zagreb-Istok, Zagreb, Hrvatska
KARIN ZIBAR TOMŠIĆ
orcid.org/0000-0002-1694-6891
; Zavod za endokrinologiju, Klinički bolnički centar Zagreb, Zagreb, Hrvatska
DARKO KAŠTELAN
orcid.org/0000-0003-3034-5598
; Zavod za endokrinologiju, Klinički bolnički centar Zagreb, Zagreb, Hrvatska; Medicinski fakultet Zagreb, Sveučilište u Zagrebu, Zagreb, Hrvatska
TINA DUŠEK
orcid.org/0000-0002-1266-3501
; Zavod za endokrinologiju, Klinički bolnički centar Zagreb, Zagreb, Hrvatska; Medicinski fakultet Zagreb, Sveučilište u Zagrebu, Zagreb, Hrvatska
Sažetak
Introduction: Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus (DM). In some studies, infections have been found to be a precipitating factor in more than half of the subjects. On the other hand, several recent studies emphasize that poor treatment adherence is also a common cause of DKA. Objective: To identify the most common precipitating factors for DKA in Croatia. Patients and Methods: This retrospective, multicenter study included DM type 1 or DM type 2 patients diagnosed with DKA between January 1, 2014 and December 31, 2018, and treated in 5 different DM treatment centers, i.e., Dubrovnik, Našice, Split, Zagreb and Osijek. Only the fi rst episode of DKA was included in the analysis. Patients receiving steroids and DM due to endocrine disorders such as acromegaly and Cushing's syndrome were excluded. Results: The study included 160 patients (55% of men), of whom 68% had DM type 1. The mean age of the respondents was 42 (18-89) years. The most common cause of DKA was infection (57%), followed by poorly controlled DM (37%) and fi rst presentation of DM (9%), while in 7% of patients DKA was due to other causes such as insulin pump failure, stroke or myocardial infarction. In the group of patients with infections, urinary tract infections (30%), gastrointestinal infections (30%) and respiratory tract infections (19%) were most common, whereas 21% of patients had other sources of infection. In 36% of these patients, the infection was associated with previously poorly controlled diabetes, and in 12% of them, DKA caused by the infection was the fi rst manifestation of the disease. In patients with type 2DM, infections were more often the cause of DKA than in patients with type 1DM (p<0.05).Poorly controlled glycemia appeared to be a more frequent cause of DKA in patients with type 1 DM (31%) than in patients with type 2 DM (18%). Conclusion: The most common precipitating factors for the development of DKA were infections and poor diabetes management. Better education of patients about the importance of regular insulin administration and correction of therapy in acute illness could reduce the risk of DKA.
Ključne riječi
diabetes, mellitus; ketoacidosis; precipitating factors; hyperglycemia; insulin; infection
Hrčak ID:
307175
URI
Datum izdavanja:
10.8.2023.
Posjeta: 385 *