Skip Navigation
Skip to contents

Endocrinol Metab : Endocrinology and Metabolism


Author index

Page Path
Manish Gutch  (Gutch M) 1 Article
Clinical Study
Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis
Avinash Agarwal, Ambuj Yadav, Manish Gutch, Shuchi Consul, Sukriti Kumar, Ved Prakash, Anil Kumar Gupta, Annesh Bhattacharjee
Endocrinol Metab. 2016;31(3):424-432.   Published online September 1, 2016
  • 4,621 View
  • 81 Download
  • 27 Web of Science
  • 26 Crossref
AbstractAbstract PDFPubReader   

Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity and mortality.


Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically and by laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted as either discharged to home or death.


The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus, systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamic oxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected to multivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorable outcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in mean APACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively, compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04).


Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of the DKA-associated mortality.


Citations to this article as recorded by  
  • Prognosis of patients with extreme acidosis on admission to the emergency department: A retrospective cohort study
    Amichai Gutgold, Shaden Salameh, Jeries Nashashibi, Yonatan Gershinsky
    The American Journal of Emergency Medicine.2024; 76: 36.     CrossRef
  • The critical role of pen needles and training in insulin delivery
    Tracey Sainsbury
    British Journal of Nursing.2024; 33(5): 242.     CrossRef
  • Clinical characteristics of people with diabetic ketoacidosis at a clinic in The Gambia: a retrospective study
    Orighomisan F Agboghoroma, Modou Jobe, Karen Forrest
    Journal of Endocrinology, Metabolism and Diabetes of South Africa.2023; 28(1): 14.     CrossRef
  • Elevated alanine transaminase is nonlinearly associated with in-hospital death in ICU-admitted diabetic ketoacidosis patients
    Qiaoling Liu, Chen Gong, Yunjie Geng, Jiuhong You
    Diabetes Research and Clinical Practice.2023; 197: 110555.     CrossRef
  • Diabetic keto-acidosis in pancreatic diabetes – how is it different from DKA in type 1 or type 2 DM?
    Sunetra Mondal, Riddhi DasGupta, Moushumi Lodh, Ashok Parida, Mandira Haldar, Arunangshu Ganguly
    International Journal of Diabetes in Developing Countries.2023;[Epub]     CrossRef
  • Comparative study of diabetic ketoacidosis in the elderly and non-elderly patients: A nine-year experience from an academic hospital in North India
    Ashok Kumar Pannu, Ravindran Kiran, Abhishek Kumar, Saurabh Chandrabhan Sharda, Mandip Bhatia, Atul Saroch, Pinaki Dutta, Navneet Sharma
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(12): 102903.     CrossRef
  • Clinical Profile and Outcome of Diabetic Ketoacidosis in Type 1 and Type 2 Diabetes: A Comparative Study
    Sachin Kamle, Madhuri Holay, Prashant Patil, Parimal Tayde
    Vidarbha Journal of Internal Medicine.2022; 32: 21.     CrossRef
  • Effect of subjective tool based aerobic exercise on pulmonary functions in patients with type 2 diabetes mellitus – a feasibility RCT
    M. Saini, J. Kaur
    Comparative Exercise Physiology.2022; 18(3): 239.     CrossRef
  • Clinical characteristics and outcomes of care in patients hospitalized with diabetic ketoacidosis
    Mohsen S. Eledrisi, Haifaa Alkabbani, Malk Aboawon, Aya Ali, Imad Alabdulrazzak, Maab Elhaj, Ashraf Ahmed, Hazim Alqahwachi, Joanne Daghfal, Salem A. Beshyah, Rayaz A. Malik
    Diabetes Research and Clinical Practice.2022; 192: 110041.     CrossRef
  • An Audit of Factors Impacting the Time to Resolution of the Metabolic Parameters in Diabetic Ketoacidosis Patients
    Muath F AlWahbi , Sami H Alharbi, Saleh A Almesned, Faisal A Alfawzan, Rayan T Alsager, Abdullah A AlHojailan, Emad A Alfadhel, Fahad G Al-Harbi
    Cureus.2022;[Epub]     CrossRef
  • Incidence of Diabetic Ketoacidosis among Adults with Type 1 Diabetes in Saudi Arabia: Systematic review
    Ayoub Ali Alshaikh, Rawan Zaifallh Alsalman, Nada Hamzah Albarqi, Razan Salem Alqahtani, Ali Ahmed Almontashri, Atheer Saud Alshahrani, Mohammed Abdullah Alshehri
    Pharmacophore.2022; 13(4): 105.     CrossRef
  • Features and long‐term outcomes of patients hospitalized for diabetic ketoacidosis
    Michal Michaelis, Tzippy Shochat, Ilan Shimon, Amit Akirov
    Diabetes/Metabolism Research and Reviews.2021;[Epub]     CrossRef
  • Incidence, characteristics and long-term outcomes of patients with diabetic ketoacidosis: a prospective prognosis cohort study in an emergency department
    Rachel Teixeira Leal Nunes, Carolina Frade Magalhães Girardin Pimentel Mota, Paulo Ricardo Gessolo Lins, Fernanda Salles Reis, Thais Castanheira de Freitas Resende, Ludmila de Andrade Barberino, Pedro Henrique Luiz da Silva, Aecio Flavio Teixeira de Gois
    Sao Paulo Medical Journal.2021; 139(1): 10.     CrossRef
  • Management of diabetic ketoacidosis in special populations
    Mohsen S. Eledrisi, Salem A. Beshyah, Rayaz A. Malik
    Diabetes Research and Clinical Practice.2021; 174: 108744.     CrossRef
  • Profile of diabetic ketoacidosis at the National Diabetes and Endocrine Center in Tripoli, Libya, 2015
    Aida Elkituni, Halla Elshwekh, Nesrein M. Bendala, Wafeya S. Atwear, Fawzia A. Aldaba, Abdulmunam M. Fellah
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2021; 15(3): 771.     CrossRef
  • Frequency of Diabetic Ketoacidosis and Its Determinants Among Pediatric Diabetes Mellitus Patients in Northwest Ethiopia
    Atitegeb Abera Kidie, Ayenew Molla Lakew, Tiruneh Ayele
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 4819.     CrossRef
  • Diabetic ketoacidosis
    Ketan K. Dhatariya, Nicole S. Glaser, Ethel Codner, Guillermo E. Umpierrez
    Nature Reviews Disease Primers.2020;[Epub]     CrossRef
  • Risk and Relevance of Insulin Pump Therapy in the Aetiology of Ketoacidosis in People with Type 1 Diabetes
    Lena Christina Giessmann, Peter Herbert Kann
    Experimental and Clinical Endocrinology & Diabetes.2020; 128(11): 745.     CrossRef
  • Clinical and biochemical profile, precipitants and prognostic factors of diabetic ketoacidosis: A retrospective study from a tertiary care center of north India
    Harpreet Singh, Atul Saroch, Ashok Kumar Pannu, H.J. Sachin, Navneet Sharma, Pinaki Dutta
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2019; 13(4): 2357.     CrossRef
  • Sudden death due to diabetic ketoacidosis following power failure of an insulin pump: Autopsy and pump data
    Mette Louise Blouner Gram Kjærulff, Birgitte Schmidt Astrup
    Journal of Forensic and Legal Medicine.2019; 63: 34.     CrossRef
  • Defining and characterising diabetic ketoacidosis in adults
    Ketan K. Dhatariya
    Diabetes Research and Clinical Practice.2019; 155: 107797.     CrossRef
  • Effects of diabetic ketoacidosis in the respiratory system
    Alice Gallo de Moraes, Salim Surani
    World Journal of Diabetes.2019; 10(1): 16.     CrossRef
  • Increasing Hospitalizations for DKA: A Need for Prevention Programs
    Priyathama Vellanki, Guillermo E. Umpierrez
    Diabetes Care.2018; 41(9): 1839.     CrossRef
  • Guidelines and controversies in the management of diabetic ketoacidosis – A mini-review
    Tasnim Islam, Khalid Sherani, Salim Surani, Abhay Vakil
    World Journal of Diabetes.2018; 9(12): 226.     CrossRef
  • Closing the Mortality Gap in Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State: Implications of a Clinical Decision Support App
    Saperstein Y, Park J, McFarlane SI
    International Journal of Clinical Endocrinology and Metabolism.2018; : 008.     CrossRef
  • Incidence and prevalence of diabetic ketoacidosis (DKA) among adults with type 1 diabetes mellitus (T1D): a systematic literature review
    Soulmaz Fazeli Farsani, Kimberly Brodovicz, Nima Soleymanlou, Jan Marquard, Erika Wissinger, Brett A Maiese
    BMJ Open.2017; 7(7): e016587.     CrossRef
Close layer

Endocrinol Metab : Endocrinology and Metabolism