Recognizing the main signs and symptoms of diabetic ketoacidosis: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i12.20149

Keywords:

Diabetic ketoacidosis; Signs and symptoms; Diabetes Mellitus; Emergencies; Diagnosis.

Abstract

Objective: to identify the main signs and symptoms of diabetic ketoacidosis evidenced in the scientific literature. Methodology: this is an integrative literature review, developed from May to June 2021. The search was performed through the journal portal Coordination for the Improvement of Higher Education Persons, in the following databases: Excerpta Medical data BASE, Medical Literature Analysis and Retrieval Online System and Latin American and Caribbean Literature in Health Sciences. The search strategy consisted of crossing the descriptors “Diabetic Ketoacidosis”, “Signs and Symptoms Diagnosis”, mediated by the Boolean operator “AND”. Articles published from 2017 to 2021 in Portuguese, English and Spanish were included. Gray literature studies and duplicate articles were excluded. Results: 423 studies were investigated, and of these, only seven met the eligibility criteria. Polydipsia, polyuria and weight loss were identified as the most frequent symptoms among patients diagnosed with diabetic ketoacidosis. As for recognition, there was a low level of identification of signs and symptoms of diabetic ketoacidosis by parents of children with diabetes mellitus and health professionals. As well, it was verified the influence of age and socioeconomic level on the prevalence of this endocrine emergency. Conclusion: a reduced recognition of signs and symptoms of diabetic ketoacidosis was noticed, in addition to the low specificity of the symptomatology of this complication, which makes diagnosis, control and monitoring difficult.

References

de Sousa, L. M. M., Marques-Vieira, C. M. A., Severino, S. S. P., & Antunes, A. V. (2017). A metodologia de revisão integrativa da literatura em enfermagem. Revista Investigação em Enfermagem, 21(2), 17-26. http://www.sinaisvitais.pt/images/stories/Rie/RIE21.pdf

French, E. K., Donihi, A. C., & Korytkowski, M. T. (2019). Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients. Bmj, 365, 1-15. https://doi.org/10.1136/bmj.l1114

Grevenstuk, T., Amálio, S., & Lopes, A. (2021). Fatores de Risco para a Cetoacidose Diabética na Região do Algarve. Revista Portuguesa de Diabetes, 16(1), 55-61. http://www.revportdiabetes.com/wp-content/uploads/2021/07/RPD_Junho_2021_ARTIGO-ORIGINAL_55-61.pdf

Hadgu, F. B., Sibhat, G. G., & Gebretsadik, L. G. (2019). Diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in Tigray, Ethiopia: retrospective observational study. Pediatric health, medicine and therapeutics, 10, 49-55. 10.2147/PHMT.S207165

International Diabetes Federation (2017). Diabetes Atlas.

Iovane, B., Cangelosi, A. M., Bonaccini, I., Di Mauro, D., Scarabello, C., Panigari, A., & Vanelli, M. (2018). Diabetic ketoacidosis at the onset of Type 1 diabetes in young children: Is it time to launch a tailored campaign for DKA prevention in children< 5 years? Acta Bio Medica: Atenei Parmensis, 89(1), 67-71. 10.23750/abm.v89i1.6936

Jasem, D., Majaliwa, E. S., Ramaiya, K., Najem, S., Swai, A. B. M., & Ludvigsson, J. (2019). Incidence, prevalence and clinical manifestations at onset of juvenile diabetes in Tanzania. Diabetes research and clinical practice, 156, 1-6. https://doi.org/10.1016/j.diabres.2019.107817

Kruljac, I., Ćaćić, M., Ćaćić, P., Biloš, L. S. K., Ostojić, V., Blaslov, K., & Vrkljan, M. All-cause mortality prognostic factors in type 2 diabetes-associated ketosis and ketoacidosis. Endocrine Oncology and Metabolism, 4(1), 12-22. 10.21040/eom/2018.4.1.4

Lopes, C. L., Pinheiro, P. P., Barberena, L. S., & Eckert, G. U. (2017). Diabetic ketoacidosis in a pediatric intensive care unit. Jornal de pediatria, 93, 179-184. https://doi.org/10.1016/j.jped.2016.05.008

Mencher, S. R., Frank, G., & Fishbein, J. (2019). Diabetic ketoacidosis at onset of type 1 diabetes: rates and risk factors today to 15 years ago. Global pediatric health, 6, 1-6. 10.1177/2333794X19870394

Oliveira, J. E. P. D., & Vencio, S. (2017). Diretrizes da Sociedade Brasileira de Diabetes 2017-2018. Editora Clannad, 91.

Pereira, M. E., & da Silva Lima, U. T. (2020). Diabetes Mellitus Tipo 1 Em Primodescompensação Por Cetoacidose Diabética: Um Relato De Caso. Revista Thêma et Scientia, 10(1), 266-275. http://www.themaetscientia.fag.edu.br/index.php/RTES/article/view/1187/1085

Prazeres, I. S., & Vargas, D. M. (2019). Perfil de crianças e adolescentes internados por diabetes mellitus em hospital de referência do SUS. Arquivos Catarinenses de Medicina, 48(2), 56-65. http://www.acm.org.br/acm/seer/index.php/arquivos/article/view/487/345

Pussoli, C. F., Malaquias, D. P., Mendonça, G. J. Z., Neves, I. C., Piotrowisky, J. L., Santos, H. D. H., & Dombroski, T. C. D. (2018). Fatores Associados À Internação Em Crianças Por Cetoacidose Diabética Em Mato Grosso De 2008 A 2017. Caderno de Publicações Univag, (09), 4-10. file:///C:/Users/Andr%C3%A9/Downloads/1204-3774-1-PB.pdf

Queiroz, M. G., de Aquino, M. L. A., Brito, A. D. L., Medeiros, C. C. M., da Silva Simões, M. O., Teixeira, A., & de Carvalho, D. F. (2020). Hipertensão arterial no idoso-doença prevalente nesta população: uma revisão integrativa. Brazilian Journal of Development, 6(4), 22590-22598. 10.34117/bjdv6n4-428

Santos, L. de B.., Oliveira, A. C. D.., & Viana, M. R. P. (2020). Factors that predispose to diabetic ketoacidosis in adolescents. Research, Society and Development, 9(10), e6929108969. https://doi.org/10.33448/rsd-v9i10.8969

Singh, H., Saroch, A., Pannu, A. K., Sachin, H. J., Sharma, N., & Dutta, P. (2019). Clinical and biochemical profile, precipitants and prognostic factors of diabetic ketoacidosis: A retrospective study from a tertiary care center of north India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(4), 2357-2360. 10.1016/j.dsx.2019.06.002

Sociedade Brasileira de Diabetes. (2018). Diretrizes da Sociedade Brasileira de Diabetes 2017-2018.

Sociedade Brasileira de Diabetes. (2019). Diretrizes da Sociedade Brasileira de Diabetes 2019-2020.

Souza Júnior, E. V. D., Jesus, M. A. S. D., Lapa, P. S., Cruz, J. S. D., Maia, T. F., Barros, V. S., & Boery, E. N. (2019). Internações, óbitos e custos hospitalares por diabetes mellitus. Rev. enferm. UFPE on line, 1-9. https://doi.org/10.5205/1981-8963.2019.240388

Souza, L. C. V. F. D., Kraemer, G. D. C., Koliski, A., Carreiro, J. E., Cat, M. N. L., Lacerda, L. D., & França, S. N. (2019). Cetoacidose diabética como apresentação inicial de diabetes tipo 1 em crianças e adolescentes: estudo epidemiológico no sul do Brasil. Revista Paulista de Pediatria, 38, 1-8. https://doi.org/10.1590/1984-0462/2020/38/2018204

Velasco, I. T., Brandão, R. A., Souza, H. P., Marino, L. O., Marchini, J. F. M., & Alencar, J. C. G., (2021). Medicina de emergência: abordagem prática. São Paulo: Editora Manole.

Villar, L. (2021). Endocrinologia Clínica. Editora Guanabara.

Yan, J. W., Spaic, T., & Liu, S. (2020). Just the Facts: Diagnosis and treatment of diabetic ketoacidosis in the emergency department. CJEM, 22(1), 19–22. https://doi.org/10.1017/cem.2019.428.

Published

13/09/2021

How to Cite

RODRIGUES, K. S.; SOUSA , A. C. de .; CARDOSO, A. N. .; GOMES, M. L. F.; AMARAL, V. F. do .; PINTO, F. J. M. .; LINARD, C. F. B. M. . Recognizing the main signs and symptoms of diabetic ketoacidosis: an integrative review. Research, Society and Development, [S. l.], v. 10, n. 12, p. e75101220149, 2021. DOI: 10.33448/rsd-v10i12.20149. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20149. Acesso em: 23 nov. 2024.

Issue

Section

Review Article