title: Characteristics of severe diabetic ketoacidoses occurring before and after 60 years of age.
abstract: Between 1978 and 1982, 459 cases of severe diabetic ketoacidosis (pH less than or equal to 7.20, total -CO2 less than or equal to 10 mMol/l) were admitted to our Intensive Care Unit. 416 (241 males, 175 females) were under 60 years (41 +/- 7) and 43 (22 males, 21 females) exceeded 60 years of age (67 +/- 7). The precipitating causes were fairly similar, in both groups, with infections foremost (68%). Presenting biochemical parameters, before and after 60 years showed differences in: blood glucose: 32.7 +/- 12 versus 34.8 +/- 8.1 mMol/l; plasma sodium 137 +/- 14 versus 143 +/- 16 mMol/l; plasma potassium 4.2 +/- 0.9 versus 4.9 +/- 0.7 mMol/l; hydrogen ion concentration 95 +/- 17 versus 73 +/- 12 mMol/l, (p less than 0.01); plasma osmolarity 327 +/- 98 versus 379 +/- 96 mOsm/l. The difference was significant (p less than 0.01) in frequency of hypernatremic hyperosmolarity (initial sodium greater than 147 mMol/l): 7.4% of 202 cases before age 60 years versus 24.1% of 29 case after age 60 years. The fluid amounts administered i.v. within the first 24 h was greater before (7516 +/- 2121 ml; p less than 0.01) than after 60 years (5276 +/- 1132 ml); insulin requirements were greater after 60 years (236 +/- 78 U/24 h; p less than 0.01) than before the age of 60 years (182 + 59 U/24 h). The mortality rate in the course of severe diabetic ketoacidoses was significantly lower before 60 years (1.3%, p less than 0.01) as against 6.9% after age 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D003926:Diabetic Coma / Q000453:epidemiology; D016883:Diabetic Ketoacidosis / Q000378:metabolism* / Q000628:therapy; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011188:Potassium / Q000627:therapeutic use; D012964:Sodium / Q000097:blood
chemical_list: D001786:Blood Glucose; D007328:Insulin; D007773:Lactates; D012964:Sodium; D011188:Potassium