Investigation of the relationship between biochemical parameters and coma severity and morbidity and mortality in diabetic ketoacidose

Purpose: Diabetes Mellitus (DM) is becoming an important health problem that is rapidly increasing worldwide. Diabetic ketoacidosis (DKA) is one of the most common and potentially fatal acute complications of diabetes. Despite all the advances in diabetes treatment today, DKA can still cause mortality and morbidity. The aim of this study is to compare the relationship between some laboratory parameters and pH and the time to recovery from ketoacidosis in patients diagnosed with DKA and treated in the endocrinology clinic, and to investigate its effects on morbidity and mortality. Material and Method: 50 patients diagnosed with DKA and treated at Firat University Faculty of Medicine Hospital Adult Endocrinology and Metabolic Diseases Clinic between September 2023 and July 2024 were included in our study. Data including age, gender, height and body weight measurements of all patients were recorded. Just before starting DKA treatment, 5 cc venous blood samples were taken from all patients for biochemical parameters and 1 cc arterial blood sample was taken for arterial blood gas (ABG) analysis. All patients had serum sodium (Na), potassium (K), magnesium (Mg), uric acid (UA), phosphorus (P), C-reactive peptide (CRP), cortisol, Vitamin D3, vitamin B12, Thyroid Stimulating Hormone (TSH), pH, bicarbonate (HCO3), lactate, neutrophil count, platelet (PLT) count and mean platelet volume (MPV) values were measured. The time from the beginning of DKA treatment to the resolution of ketoacidosis was recorded for all patients Laboratory data were compared separately with pH and ketoacidosis recovery times. All results were analyzed statistically. Findings: 28 (56.0%) of the patients were female and 22 (44.0%) were male. The median age of the patients was 46.0 (18.0-85.0) years. The average pH values of the patients measured on AKG were 7.2 (6.9-7.3), and the average HCO3 values were 11.0 mEq/L (3.0-18.0). The average recovery time for ketoacidosis was measured as 24.0 hours (5-96). There was an inverse correlation between serum K, neutrophil and platelet counts and pH (r=-0.453; p=0.001, r=-0.561; p<0.001 and r=-0.561; p<0.001, respectively). There was a similar correlation between vitamin D levels and pH (r=0.298; p=0.050). There was an inverse correlation between pH and HCO3 levels in FBG and the recovery time of DKA (r=-0.406; p=0.003, r=-0.382; p=0.006, respectively). No relationship was detected between serum Na, P, Mg, UA, CRP, vitamin B12, TSH, cortisol and MPV values and pH and ketoacidosis recovery time. Conclusion: The findings of our study showed that there was an inverse correlation between DKA severity and K, lactate, Neutrophil and PLT values, and a same correlation with vitamin D levels. It also showed that there was a negative correlation between the recovery time of ketoadiosis and pH and HCO3 values, and that there was no correlation with other laboratory parameters.