Therapeutic and evolutionary characteristics of Diabetic ketosis decompensations after a decade at the University Hospital of Cotonou, Benin

Abstract

Aim: To evaluate the therapeutic and evolutionary aspects of diabetic ketosis decompensation, a decade after its previous report in our center. Materials and Method: This was a 3-year retrospective study, including all patients admitted from June 1, 2016 to May 31, 2019 for DKA at the Endocrinology and Metabolic Diseases Department of the National and University Hospital Hubert Koutoukou Maga (CNHU-HKM). Ketosis was defined by the presence of at least 2 acetone crosses on the urine strip. Results: A total of 196 patients were included. The mean age was 43.73 years ± 16.2 years with a sex ratio of 0.96. The prevalence of DKA was 28.99%. The main precipitating factors of DKA were infections (67.86%) and non-compliance to the treatment (29.59%). The most common infections were urogenital (23.30%), respiratory (18.04%) and malaria (32.33%). The mortality was 2.55%. Male subjects (84.36%) had blood glucose levels above 3g/L with a higher mean dose of insulin used (84.71 IU versus 54.29 IU for women p=0.008). Duration of recovery (p=0.008) and length of hospitalization (p=0.006) were statistically longer for men. Conclusion: The prevalence of ketosis decompensations remains high. The main decompensation factors found were infections and non-compliance to treatment. Improving patient care over the past decade had produced a positive impact on mortality, recovery time and length of hospitalization.