Analysis of the safety and efficacy of diabetic ketoacidosis management in a community general hospital, 2001–2010

A descriptive study

E. Peeters, W. J. Van Ijperen, L Robertson, P. Royle, W J Van Ijperen

Research output: Contribution to journalArticle

Abstract

Background: The recommended place for treatment of diabetic ketoacidosis in children is a paediatric High Dependency Unit. This facility is not available in all areas where children with type 1 diabetes mellitus are cared for. 

Aims: This study investigates the safety and efficacy of diabetic ketoacidosis management in a community general hospital without a paediatric high dependency unit.

 Methods: Data from children with diabetic ketoacidosis were collected from all diabetes related admissions in Dr Gray’s Hospital, Elgin from 2001 to 2010. Observations were compared with safety indicators (pH, bicarbonate, glucose, electrolytes and cerebral oedema) and were reviewed for the recovery to normal values (pH, bicarbonate), without abnormal fluctuation (electrolytes, glucose) and without neurological complications (cerebral oedema). Results: The 114 patients generated 251 diabetes-related admissions, 118 for diabetic ketoacidosis treatment of whom 99 patients were treated with intravenous fluids and insulin. The mean time to recover to a pH of at least 7.30 was 655 minutes (120–1410 min). There were 79 (4.37% of 1808) glucose readings dropping more than 5.0 mmol/l per hour. There were six hypoglycaemic events (2.3–2.9 mmol/l) and in one case potassium dropped to 2.2 mmol/l. There was no case which developed into cerebral oedema.

 Conclusion: Treatment of diabetic ketoacidosis in a community general hospital managed with a protocol for fluids, insulin and strict monitoring has shown to be effective in achieving recovery and to safely avoid complications.

Original languageEnglish
Pages (from-to)121-125
Number of pages5
JournalScottish Medical Journal
Volume60
Issue number3
Early online date8 Jul 2015
DOIs
Publication statusPublished - Aug 2015

Fingerprint

Diabetic Ketoacidosis
Community Hospital
General Hospitals
Brain Edema
Safety
Bicarbonates
Glucose
Electrolytes
Insulin
Pediatrics
Type 1 Diabetes Mellitus
Hypoglycemic Agents
Reading
Potassium
Reference Values
Therapeutics

Keywords

  • Diabetic ketoacidosis
  • Hyperglycaemia
  • Management of DKA in CGH

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Analysis of the safety and efficacy of diabetic ketoacidosis management in a community general hospital, 2001–2010 : A descriptive study. / Peeters, E.; Van Ijperen, W. J.; Robertson, L; Royle, P.; Van Ijperen, W J.

In: Scottish Medical Journal, Vol. 60, No. 3, 08.2015, p. 121-125.

Research output: Contribution to journalArticle

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abstract = "Background: The recommended place for treatment of diabetic ketoacidosis in children is a paediatric High Dependency Unit. This facility is not available in all areas where children with type 1 diabetes mellitus are cared for. Aims: This study investigates the safety and efficacy of diabetic ketoacidosis management in a community general hospital without a paediatric high dependency unit. Methods: Data from children with diabetic ketoacidosis were collected from all diabetes related admissions in Dr Gray’s Hospital, Elgin from 2001 to 2010. Observations were compared with safety indicators (pH, bicarbonate, glucose, electrolytes and cerebral oedema) and were reviewed for the recovery to normal values (pH, bicarbonate), without abnormal fluctuation (electrolytes, glucose) and without neurological complications (cerebral oedema). Results: The 114 patients generated 251 diabetes-related admissions, 118 for diabetic ketoacidosis treatment of whom 99 patients were treated with intravenous fluids and insulin. The mean time to recover to a pH of at least 7.30 was 655 minutes (120–1410 min). There were 79 (4.37{\%} of 1808) glucose readings dropping more than 5.0 mmol/l per hour. There were six hypoglycaemic events (2.3–2.9 mmol/l) and in one case potassium dropped to 2.2 mmol/l. There was no case which developed into cerebral oedema. Conclusion: Treatment of diabetic ketoacidosis in a community general hospital managed with a protocol for fluids, insulin and strict monitoring has shown to be effective in achieving recovery and to safely avoid complications.",
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