Diabetic Ketdacidosis At The Kenyatta National Hospital.a Prospective Study:1981-1982."presentation,precipitating Factors.mortality And Problems Of Management"

Abstract

30 patients presenting to the Kenyatta National Hospital in diabetic ketoacidosis were each subjected to a well tried regimen of therapy, namely "small dose-intramuscular insulin" regimen. Besides insulin every patient received intravenous fluids, intravenous potassium supplementation and a broad spectrum antibiotic as an adjunct to the general considerations of a very ill patient. The presentation of diabetic ketoacidosis at the Kenyatta National Hospital was found to be similar to that elsewhere. Infection was the precipitating factor in the majority of patients (60%). The small dose intramuscular insulin regimen was found to be simple, safe and effective. The mortality rate for diabetic ketoacidotic patients treated was 16.7% (cf. 29% in 1975 and 33% in 1978-80). At the Kenyatta National Hospital laboratory backup was found to be very inadequate, a factor which in the author's opinion contributed to the high mortality figure.