Abstract

Background: Diabetic ketoacidosis (DKA) is relatively common in acute metabolic decompensation among diabetic patients. It usually happens among patients of diabetes mellitus who have stopped captivating insulin or have any type of infection. The management of DKA includes correcting dehydration, hyperglycemia, electrolyte disturbances, acidosis, and antibiotics or treating another triggering cause, as appropriate, in patients with one type of infection.

Objective: To study the role of Insulin and Intravenous Fluid in the treatment of Diabetic Ketoacidosis to overt the Diabetic Ketoacidosis crisis

Methods: This was across-sectional study conducted in the Medicine department of KGN Teaching hospital Bannu and District Headquarter Teaching hospital Bannu for duration of six months from 15 February 2020 to 15 August 2020, which enrolled 70 patients with diabetic ketoacidosis who met exclusion and inclusion criteria for the total volume of I.V fluid (saline) required for diabetic ketoacidosis treatment.

Results: DKA was more common in formerly detected diabetic patients (52.85%), more often in the low-income population and who live in village population and there was no significant gender difference. Vomiting (51.42%), nausea (28.57infections (35.71), abdominal pain (30%) as well as polyuria (25.7%) and polydipsia (18.57%) were common. In most cases, there was poor glycemic control. The missed doses of insulin and Infection were the chief reasons for development of DKA. In most cases, there was poor glycemic control. Maximum number of the subjects had acidosis of mild to moderate level and severe electrolyte disturbances were rare. The results (87.88% survival) were comparable to the result in developing countries. Eleven liters of fluid was needed in 35.71% of patients to treat DKA, which increased the amount of urine excreted. 25.71% of patients required 91–100 units of insulin to be treated for acidosis.

Conclusion: The treatment and diagnosis of diabetic ketoacidosis is not tough if detected initially. To avoid any mortality; it is necessary to replace adequate fluid.

Key words: Diabetic ketoacidosis, Diabetes, intravenous fluid and insulin