title: [Ketoacidosis in type 1 diabetes mellitus: 73 cases in Dakar].
abstract: BACKGROUND
  The follow-up of diabetes mellitus in children and teenagers remains a challenge. Ketoacidosis is the most frequent acute metabolic complication and is of bad prognosis. The objective of this study was to evaluate etiologicals factors of decompensation and evolutions in type 1 diabetes.
  
  
  METHODS
  We conducted a transversal and prospective study from January 2009 to October 2010. All type 1 diabetic patients hospitalized for ketoacidosis had been included. For every patient, we have studied the epidemiologicals, etiologicals and clinicals factors as well as the outcomes.
  
  
  RESULTS
  The prevalence was to 55.3 % among all ketoacidosis. Sex-ratio (Men/Women) was 0.78, mean age to 25.73 years and mean duration of diabetes was 3.9 years. Ketoacidosis was inaugural in 26 % of cases. Except Kussmaul dyspnea, prevailed digestives symptoms (87.6 %). Coma was noted in 82.1 % among whom 54.7 % had no previous diabetic follow-up. A decompensation factor was found in 93.1 % of which an infection (78 %) or stop insulin (53.42 %). Prevailing infectious sites were urogenitals (24.6 %), respiratories (20.5 %). The outcome was fatal in 6.8 % of the cases. It was about 24.3 years middle-aged, 1,6 year diabetes mellitus mean duration, without regular follow-up in 80 % of the cases. Other associated factors were coma stage 2 or 3 (80%), infection (60 %), hypokalemia (40 %).
  
  
  CONCLUSIONS
  Ketoacidosis is frequent in type 1 diabetic patients and has a bad prognosis. Infection and stop insulin are major factors of decompensation. Its prévention requires an adapted therapeutic education associated to a regular follow-up of patients.
authors: Clinique médicale II, Centre Hospitalier Abass NDAO, UCAD, Dakar, Senegal.
authors: A
authors: A
authors: Sarr
authors: D
authors: D
authors: Diedhiou
authors: N M
authors: NM
authors: Ndour-Mbaye
authors: Y M
authors: YM
authors: Leye
authors: M S
authors: MS
authors: Ka-Cisse
authors: A
authors: A
authors: Leye
authors: S N
authors: SN
authors: Diop
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D016883:Diabetic Ketoacidosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012675:Senegal / Q000453:epidemiology; D055815:Young Adult