Role of HbA1c and duration of diabetes in predicting mortality in patients of diabetic ketoacidosis in type II diabetes mellitus

Background: Previous studies have reported the presence of diabetes ketoacidosis in patients of type 2 diabetes mellitus (T2DM). India reported that up to 30% of hospitalized DKA cases result in inpatient death. Aims and objectives of the study was to study the role of HbA1c and duration of diabetes in outcome of patients of diabetic ketoacidosis in type 2 diabetes mellitus.Methods: Hundred T2DM patients having DKA admitted in the Department of Medicine, Gandhi Medical College and Hamidia Hospital, Bhopal, were included. Data on demography (age, sex and diabetes duration, random blood sugar (RBS) and glycated hemoglobin (HbA1c) were recorded for each patients. Outcome was also recorded and compared with duration of diabetes and HbA1c level.Results: DKA was more common in age group of51-55 years (21%) with mean age of 56.10±10.40 years. Male preponderance was observed. Mean duration of diabetes, hemoglobin, random blood sugar (RBS) and HbA1c were 7.28±3.81 years, 9.8±1.42 gm%, 351.72±22.32 mg/dl, and 7.14±0.10 respectively. Mortality was higher among the patients with longer duration of diabetes (23.1%; p=0.012) and higher HbA1c (25%, p>0.05).Conclusions: Duration of diabetes play a significant role in deciding mortality in T2DM patients with DKA however HbA1c has no role in that

Evaluating the relationship between serum uric acid levels with Killip classification suggestive of left heart failure in acute myocardial infarction

Background: Present evidence shows that increased uric acid level is a negative prognostic factor in patients with moderate to severe heart failure. A study has highlighted a correlation between serum uric acid levels and Killip class in patients of acute myocardial infarction (AMI). Aim of this study the relationship between serum uric acid level and Killip classification in patients with AMI.Methods: Sixty patients with AMI were studied prospectively in Department of Medicine/ Department of Cardiology, JA Group of Hospitals between 2016-2018. Patients were grouped based on the Killip class. Age, sex, history of smoking, alcohol consumption, hypertension and diabetes were recorded. Serum uric acid level were measured on Day 1, 3 and 5, which was compared with Killip class.Results: Majority of the patients were males (65%) and had age between (28.3%) 51-60 years. No significant association was obtained between any risk factors of AMI and Killip’s class (p>0.05). Serum uric acid levels were significantly higher in Killip grade III (7.80±3.57) as compared to Killip’s grade II (6.64±2.88) and I (6.30±2.33) (p=0.014). Majority of the patients with Killip’s grades I and II, had uric acid level ≤7.0 mg/dl (n=18 and n=9 respectively) (p=0.040). Serum uric acid was equally distributed among different types of killip’s grades between patients who expired and survived. (p>0.05).Conclusions: Serum uric acid levels has been found to be well correlated with Killip classification in patients with AMI. Combination of Killip class and serum uric acid level after AMI is a good predictor of mortality after AMI