Ketoacidosis in type 1 diabetes mellitus: 73 cases in Dakar

• Published in: Le Mali medical Vol. 26; no. 4; p. 50
• Main Authors: Sarr, A, Diedhiou, D, Ndour-Mbaye, N M, Leye, Y M, Ka-Cisse, M S, Leye, A, Diop, S N
• Format: Journal Article
• Language: French
• Published: Mali 2011
• Subjects: Adolescent; Adult; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - epidemiology; Diabetic Ketoacidosis - epidemiology; Female; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Senegal - epidemiology; Young Adult; Senegal

The follow-up of diabetes mellitus in children and teenagers remains a challenge. Ketoacidosis is the most frequent acute metabolic complication and is of bad prognosis. The objective of this study was to evaluate etiologicals factors of decompensation and evolutions in type 1 diabetes. We conducted a transversal and prospective study from January 2009 to October 2010. All type 1 diabetic patients hospitalized for ketoacidosis had been included. For every patient, we have studied the epidemiologicals, etiologicals and clinicals factors as well as the outcomes. The prevalence was to 55.3 % among all ketoacidosis. Sex-ratio (Men/Women) was 0.78, mean age to 25.73 years and mean duration of diabetes was 3.9 years. Ketoacidosis was inaugural in 26 % of cases. Except Kussmaul dyspnea, prevailed digestives symptoms (87.6 %). Coma was noted in 82.1 % among whom 54.7 % had no previous diabetic follow-up. A decompensation factor was found in 93.1 % of which an infection (78 %) or stop insulin (53.42 %). Prevailing infectious sites were urogenitals (24.6 %), respiratories (20.5 %). The outcome was fatal in 6.8 % of the cases. It was about 24.3 years middle-aged, 1,6 year diabetes mellitus mean duration, without regular follow-up in 80 % of the cases. Other associated factors were coma stage 2 or 3 (80%), infection (60 %), hypokalemia (40 %). Ketoacidosis is frequent in type 1 diabetic patients and has a bad prognosis. Infection and stop insulin are major factors of decompensation. Its prévention requires an adapted therapeutic education associated to a regular follow-up of patients.