Effect of using standardised Queensland statewide diabetic ketoacidosis management protocol

Thuzar, Moe, Tisdell, Ben, Malabu, Usman, and Sangla, Kunwarjit (2012) Effect of using standardised Queensland statewide diabetic ketoacidosis management protocol. In: Annals of the Australasian College of Tropical Medicine (13) pp. 33-34. From: Townsville Hospital Research Week, 8-12 October 2012, Townsville, QLD, Australia.

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Background / Aims: Diabetic Ketoacidosis (DKA) is a serious acute complication of diabetes mellitus and causes significant morbidity and mortality if not effectively managed. A standardised statewide DKA management protocol was introduced at the Townsville hospital in 2010, but its effect on clinical outcomes has not been reviewed. This study aimed to analyse whether using the standardised protocol improves clinical outcomes compared to previous non-standardised practice in the acute management of DKA.

Methods: A retrospective hospital record audit was carried out on 71 DKA admissions between 1 January 2008 and 14 March 2012. Patients younger than 16 years were excluded. The protocol group consisted of eligible admissions managed as per protocol (from 01/01/2010 to 14/03/2012). Admissions prior to 01/01/2010 served as the control group. Groups were compared on total dose and duration of IV insulin, total amount of IV fluid,average BGL reduction, mean time taken for normalisation of serum bicarbonate, length of hospitalisation, incidence of hypokalaemia and incidence of hypoglycaemia.

Results: 35 admissions (n=35) in the protocol group, and 36 admissions (n=36) in the control group were analysed. The protocol group had shorter mean time to normalise serum bicarbonate (15.1hr for protocol vs. 24.6hr for control, P=0.01), and mean length of hospitalisation (37.9hr vs. 49.2hr, P=0.01). Incidence of hypokalaemia (28.6% vs. 52.8%, P=0.038) and hypoglycaemia (8.6% vs. 28%, P=0.036) was also lower in the protocol group compared with the control group.

Conclusion: Using the standardised Queensland statewide DKA protocol improved several clinical outcomes in acute management of DKA.

Item ID: 28548
Item Type: Conference Item (Abstract / Summary)
ISSN: 1448-4706
Date Deposited: 08 Sep 2013 23:47
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 100%
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