ackground : To characterize the IDLM in Korea, we analyzed the epidemiological and
clinical features of DKA in 72 patients.
Metod : seventy-two cases those who met the following dignostic criteria were included in
the anaysis. 1)Clinical manifestation of typical DKA,2)Blood glucose level>250
mg/dl,3)Presence of ketonuria or ketonemia, 4)Blood pH<7.34
Results :
1) The occurrence of DKA was higher in the young and in female.
2) DKA occurred most frequently in colder season with apparent two peaks in March and
December.
3) In 23.6% DKA was the first clinical presentation of diabetes and in the remainders,
diabetes was known to be present for average of 5.4 years.
4) The most common precipitating factors of DKA was infection and omission of therapy
was the next. No discernible precipitating factor was found in 26.4% of DKA cases.
5) Polyuria, polydipsia, dyspnea, nausea, vomiting and abdominal pain were frequent
accompanying symptoms, and physical findings included Kussmaul breathing, tachycardia and
hypotension. The mental status of patients were alert in 55.6% of DKA cases.
6) There was no significant difference in the body temperature, PB smear, and %
neutrophils between DKA cases with infection and those without infection.
7) On admission potassium was high in 43%, but low in 23% 6 hours after therapy. In
only two-thirds of cases, fasting C-peptide level on admission was decreased in the range of
classical IDDM.
8) Hypoglycemia was the most frequent complication during the treatment of DKA
followed by hypokalemia, hypernatremia, hyperkalemia, thromboembolism and ARDS.
9) Mortality of DKA was 13.9% and poor prognostic factors include old age, azotemia,
associated bacterial pneumonia.
Conclusion : The epidemiological and clinical features of DKA in Korea were similar to
those in western coutries, in respect to female preponderance, age, seasonal distribution, % of
debut cases, precipitating factors, initial laboratory findings, complications, mortality and
prognostic factors. This observation suggests that although the incidence rate of IDDM is
low in Korea, there are cases that take clinical courses very similar to those of western
countries.
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