<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
      <JournalTitle>Archives of Medical and Clinical Research</JournalTitle>
      <Volume-Issue>Volume 2; Issue 2</Volume-Issue>
      <ArticleType>Research </ArticleType>
      <ArticleTitle>Morbimortality Analysis of Diabetic Ketoacidosis in a Second Level Hospital in Mexico</ArticleTitle>
          <FirstName>Durán Alvarado</FirstName>
          <FirstName>Maldonado Mancillas Jesús</FirstName>
          <FirstName>Landeros Sáenz</FirstName>
          <FirstName>Tinoco Álvarez Mario</FirstName>
      <Abstract>Background: Diabetic ketoacidosis (DKA) is a very frequent entity that presents as an acute complication of diabetes mellitus, in which there is a state of hyperglycemia, metabolic acidosis and ketosis. Acute complications of diabetes represent a high percentage of admissions to the emergency department of second level hospitals in Mexico.&#13;
Methods: This is a retrospective, observational, comparative, cohort and descriptive study with documented analysis technique. We obtained information from a diary of records of the intensive care unit of our hospital and included all patients older than 14 years with a diagnosis of diabetic ketoacidosis. Patients younger than 14 years were excluded as well as hyperosmolar states.&#13;
Results: Of the 1725 patients admitted to the ICU only 134 had diabetic ketoacidosis; 91% of which were of metabolic origin; 3 patients had acute pancreatitis, and complications were equal to 0.7%, being acute renal injury, urosepsis, preeclampsia and pneumonia. The most frequent age group was between 20 and 30 years old, while mortality was 10%. The incidence of diabetic ketoacidosis was more frequent in the male sex in contrast with the study of Li et al who report a predominance in the female sex. In the age group we agree with Ramphul et al. who determine an average age of 18 to 44 years in the U.S. population. Therefore, we take into account that our casuistry in Mexico is partially similar and that the tendency of diabetic ketoacidosis has been greater in the male population, as well as an increased mortality.&#13;
Conclusions: In this study involving patients with diabetic ketoacidosis, the incidence and mortality tend to be increasing in our hospital and is that related to economic and sociocultural factors given the fact that our country and hospital of origin is in the means of development.</Abstract>
      <Keywords>Ketoacidosis,Diabetes,Incidence,Acute Complications,Mortality</Keywords>
        <Abstract>https://amcrjournal.com/ubijournal-v1copy/journals/abstract.php?article_id=14138&amp;title=Morbimortality Analysis of Diabetic Ketoacidosis in a Second Level Hospital in Mexico</Abstract>
        <References>American Diabetes Association. 15. Diabetes care in the hospital: Standards of Medical Care in diabetes-2019. Diabetes Care 2019; 42(Suppl 1): S173–S181.&#13;
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2004; 27: S5–S10.&#13;
American Diabetes Association. Hyperglycemic crises in patients with diabetes mellitus. Diabetes Care 2001; 24: 154-161.&#13;
Charfen MA and Fernand;aacute;ndez-Frackelton M. Diabetic ketoacidosis. Emerg Med Clin North Am 2005; 23: 609-628.&#13;
Domand;iacute;nguez Ruiz M, Calderand;oacute;n Mand;aacute;rquez MA, Matand;iacute;as Armas R. Caracterand;iacute;sticas cland;iacute;nico epidemioland;oacute;gicas de las complicaciones agudas de la diabetes en el servicio de urgencias del Hospital General de Atizapand;aacute;n. Rev Fac Med Univ Nac Auton Mex 2013; 56: 25-36.&#13;
Guerra JM, Asenjo MM, Gand;oacute;mez PT, Pand;eacute;rez CI. Cetoacidosis diaband;eacute;tica como guand;iacute;a diagnand;oacute;stica: Caso cland;iacute;nico. Revista Mand;eacute;dica Cland;iacute;nica Las Condes 2019; 30: 323-325.&#13;
Johnson EP, Dunn M, Cooper M, Bhakta N. Diabetes Prevention Program Sites Compared with Diabetes Prevalence and Ratio of Primary Care Physicians in Texas. Prev Chronic Dis 2019; 16: E165.&#13;
Karslioglu French E, Donihi AC, Korytkowski MT. Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients. BMJ 2019; 365: 1114.&#13;
Li L, Andrews EB, Li X, Doder Z, Zalmover E, Sharma K, Oliveira JH, Juhaeri J, Wu C. Incidence of diabetic ketoacidosis and its trends in patients with type 1 diabetes mellitus identified using a U.S. claims database, 2007-2019. J Diabetes Complications 2021; 35: 107932.&#13;
Nyenwe EA and Kitabchi AE. The evolution of diabetic ketoacidosis: An update of its etiology, pathogenesis and management. Metabolism 2016; 65: 507-521.&#13;
Olivieri L and Chasm R. Diabetic ketoacidosis in the pediatric emergency department. Emergency Medicine Clinics 2013; 31: 755-773.&#13;
Osama Hamdy. Diabetic ketoacidosis (DKA). Practice Essentials, Background, Pathophysiology. Medscape 2022.&#13;
Pasquel FJ and Umpierrez GE. Hyperosmolar hyperglycemic state: a historic review of the clinical presentation, diagnosis, and treatment. Diabetes Care 2014; 37: 3124-3131.&#13;
Ramphul K and Joynauth J. An Update on the Incidence and Burden of Diabetic Ketoacidosis in the US. Diabetes Care 2020; 43: e196-e197.&#13;
Umpierrez G and Korytkowski M. Diabetic emergencies - ketoacidosis, hyperglycaemic hyperosmolar state and hypoglycaemia. Nat Rev Endocrinol 2016; 12: 222-232.</References>