CLINICAL PROFILE, COMORBIDITY BURDEN, AND PRESCRIBING PATTERNS IN DIABETIC KETOACIDOSIS: A CASE SERIES FROM A TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

Abstract

Background: Diabetic ketoacidosis (DKA) is a life-threatening acute complication of diabetes mellitus and remains one of the most frequently encountered diabetes-related emergencies, carrying appreciable morbidity and mortality if not promptly recognized and managed.

Objective: To characterize the demographic profile, presenting complaints, comorbidity burden, and pharmacotherapy prescribing pattern of patients admitted with diabetic ketoacidosis at a tertiary care hospital in Peshawar, Pakistan.

Methods: A retrospective medical chart review was conducted on 20 patients admitted with diabetic ketoacidosis to the Endocrinology Ward, Emergency Room, and Acute Medical Unit of Lady Reading Hospital, Peshawar. Structured data on demographics, presenting complaints, comorbidities, and prescribed medications were abstracted using a standardized proforma and analyzed descriptively.

Results: Of 20 DKA patients, 11 (55%) were male and 9 (45%) female. The largest age group was 10–19 years (7 patients, 35%), followed by 50–60 years (5, 25%). Most patients (12, 60%) resided in Peshawar. The commonest presenting complaints were nausea/vomiting and abdominal pain (6 patients each, 30%), followed by shortness of breath and unconsciousness (4 each, 20%). DKA occurred in the context of type 1 diabetes mellitus in 12 patients (60%) and type 2 diabetes mellitus in 3 (15%); sepsis (30%) and GIT distress (20%) were the leading associated comorbidities, with anemia, COPD, chronic and acute kidney disease, shock, urinary tract infection, and hypertension also observed. Insulin glargine (13 patients), biphasic insulin aspart (10), and human regular insulin (9) were the most frequently prescribed antihyperglycemic agents, alongside broad-spectrum antibiotics (meropenem, ceftriaxone), proton-pump inhibitors, analgesics, and anticoagulants reflecting the multi-system supportive care these patients required.

Conclusion: DKA in this tertiary care cohort disproportionately affected male patients and adolescents/young adults, was frequently precipitated by infection-related comorbidity, and required multi-drug supportive regimens alongside insulin therapy. These findings support targeted patient education for adolescents and young adults with diabetes and reinforce the importance of early infection screening in patients presenting with DKA.