Retrospective analysis of clinical characteristics of patients with diabetic ketoacidosis before and after the COVID-19 pandemic

Diabetic ketoacidosis (DKA) is one of the most common emergencies related to diabetes, and despite standardization in its management, it still has significant rates of morbidity and mortality. Our aim is to examine demographic factors, morbidity, and mortality in patients presenting with diabetic ketoacidosis, analyze the reasons for presentation, and compare the number of DKA admissions and differences in clinical presentation between the same periods during the COVID-19 pandemic and previous years. A total of 203 patients who were diagnosed, followed, and treated for diabetic ketoacidosis at Eskişehir Osmangazi University Faculty of Medicine Hospital between 01.01.2017 and 31.05.2023 were included in the study. Admissions were divided into two groups as pre- and post-COVID-19 pandemic: 01.01.2017-10.03.2020 and 11.03.2020-31.05.2023. The reasons predisposing to diabetic ketoacidosis, the severity of diabetic ketoacidosis, and the final outcomes were compared both clinically and with laboratory features based on these two periods. In our study, it was found that of the 203 patients meeting the study criteria, 75 (36.94%) were admitted before the pandemic, and 128 (64.06%) were admitted during the post-pandemic period. The most common causes of diabetic ketoacidosis were infections, dietary non-compliance, and treatment non-compliance. Among infections, the most frequent cause was urinary tract infection. CRP levels of patients in the post-COVID-19 period were found to be statistically significantly higher compared to the pre-pandemic period. We recommend that to prevent uncontrolled hyperglycemia and ensure proper treatment, patients should receive nutritional counseling with the support of a dietitian, and education should be provided for the correct and regular use of prescribed medical treatments. Patients should also be advised to attend regular check-ups. During these check-ups, a full urinalysis test should be examined to detect diabetic ketoacidosis, a detailed medical history should be obtained, symptoms should be assessed for infections, and a thorough physical examination should be conducted. Key Words: Diabetic Ketoacidosis, COVID-19 pandemic, hyperglycemia