Acidosis

The prime determinant of depressed sensorium in diabetic ketoacidosis

Ebenezer Nyenwe, Laleh N. Razavi, Abbas E. Kitabchi, Amna N. Khan, Jim Wan

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVE - The etiology of altered sensorium in diabetic ketoacidosis (DKA) remains unclear. Therefore, we sought to determine the origin of depressed consciousness in DKA. RESEARCH DESIGN AND METHODS - We analyzed retrospectively clinical and biochemical data of DKA patients admitted in a community teaching hospital. RESULTS - We recorded 216 cases, 21% of which occurred in subjects with type 2 diabetes. Mean serum osmolality and pH were 304 ± 31.6 mOsm/kg and 7.14 ± 0.15, respectively. Acidosis emerged as the prime determinant of altered sensorium, but hyperosmolarity played a synergistic role in patients with severe acidosis to precipitate depressed sensorium (odds ratio 2.87). Combination of severe acidosis and hyperosmolarity predicted altered consciousness with 61% sensitivity and 87% specificity. Mortality occurred in 0.9% of the cases. CONCLUSIONS - Acidosis was independently associated with altered sensorium, but hyperosmolarity and serum "ketone" levels were not. Combination of hyperosmolarity and acidosis predicted altered sensorium with good sensitivity and specificity.

Original languageEnglish (US)
Pages (from-to)1837-1839
Number of pages3
JournalDiabetes Care
Volume33
Issue number8
DOIs
StatePublished - Aug 1 2010

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Diabetic Ketoacidosis
Acidosis
Consciousness
Sensitivity and Specificity
Community Hospital
Ketones
Serum
Teaching Hospitals
Osmolar Concentration
Type 2 Diabetes Mellitus
Research Design
Odds Ratio
Mortality

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Acidosis : The prime determinant of depressed sensorium in diabetic ketoacidosis. / Nyenwe, Ebenezer; Razavi, Laleh N.; Kitabchi, Abbas E.; Khan, Amna N.; Wan, Jim.

In: Diabetes Care, Vol. 33, No. 8, 01.08.2010, p. 1837-1839.

Research output: Contribution to journalArticle

Nyenwe, Ebenezer ; Razavi, Laleh N. ; Kitabchi, Abbas E. ; Khan, Amna N. ; Wan, Jim. / Acidosis : The prime determinant of depressed sensorium in diabetic ketoacidosis. In: Diabetes Care. 2010 ; Vol. 33, No. 8. pp. 1837-1839.
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