Profiles of Diabetic Ketoacidosis in Multiethnic Diabetic Population of Malaysia

Purpose: To outline first-time patient profiles of diabetic ketoacidosis (DKA) in the absence of reported incidence and mortality rates of DKA in Malaysian diabetic population. Methods: A retrospective cross-sectional study was designed and all medical records of patients with a discharge note of DKA were reviewed. Admissions from January 2009 to December 2011 were included. Data were analyzed in terms of socio-demographic variables in order to provide incidence and mortality rates. Medical history, as well as physical and biochemical characteristics were analyzed to report epidemiology of DKA patients. Results: Out of a total of 207 admissions for DKA, 132 were selected for the present study. Female (62.9 %), Malay ethnic (47.0 %) and the elderly (45.1 years and above) contributed most to DKA episodes. Type 2 diabetes mellitus (51.1 %) patients were prone to develop DKA. Most patients experienced mild to moderate episode of DKA by the time they sought medical attention. Although, there was no significant relationship between chronic co-morbidity and occurrence of DKA, hypertension (54.5 %), dyslipidemia (43.0 %) and cardiac disorders (35.6 %) were, however, the most frequently observed co-morbidities. Non-adherence (43.2 %), sepsis (31.9 %) and respiratory tract infection (12.2 %) were the most encountered precipitating factors for DKA episode. Mortality rate was as high as 17.6 %. Conclusion: With a higher incidence and mortality rate of DKA in Malaysia, the patterns observed in this study seem to be different from those of developed nations. Further extended studies need to be undertaken to elaborate regional and national patterns of DKA.