Title: Study of Serum Phosphate levels and its clinical significance in Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State
Authors: Anand L Betdur, Shruthi K R, Ashwath S V, Shashidharan B
DOI: https://dx.doi.org/10.18535/jmscr/v4i10.119
Abstract
Aim: The aim of the study was to access mortality in Diabetic Keto Acidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS)with special reference to serum Phosphate levels.
Methods: It was a across sectional study conducted on patients with Type 1 and type 2 Diabetes Mellitus (DM), admitted with DKA and HHS in emergency ward and Intensive care unit of a tertiary care hospital in Bengaluru, during the period September 2014 to August 2015.Serum phosphate levels were measured in all the patients on day 0, day 1 and before discharge or death . Patients were treated as per the standard protocol. Type 1 and Type 2 DM patients were identified separately. Patients with DKA and HHS were also put in two separate groups. Mortality in the two groups was correlated with serum Phosphate levels by applying Chi Square test.
Results: We had 31 males and 19 female patients. Out of them 16 belonged to type 1 DM and 34 were type 2 DM. 39 of the 50 patients had DKA and 11 had HHS. Infection and noncompliance of treatment were the major precipitating factors of DKA /HHS. 6 patients (12%) expired. Mean phosphate level in the mortality group was 2.14 mg% and 3.03 mg% in those who survived. 93% of the patients who recovered had normal phosphate levels at discharge, where as 83% of the patients in the mortality group had low serum phosphates.
Conclusion: Though Phosphate therapy is not routinely required during the treatment of acute Diabetic Hyperglycemic emergencies, they should not be ignored. If hypophosphatemia is severe or if the patient develops cardio respiratory distress, phosphate should be administered under close supervision.
Key words: Diabetic ketoacidosis, Hyperglycemic hyperosmolar state, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Serum Phosphate levels,
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