Serological Prediction of infections in Diabetic Patients with Diabetes Ketoacidosis in Penang, Malaysia

Purpose: To determine the prevalence and predictors of infection in diabetic patients with diabetic ketoacidosis (DKA) who were ≥18 years. Methods: A retrospective cohort design was adopted for this study. A total of 967 diabetes ketoacidosis patients from Hospital Pulau Pinang for the 3-year period, Jan 2008 - Dec 2010, were identified and enrolled. The data were analysed, as appropriate, by Student t-test and ANOVA for the normally distributed data, Mann-Whitney U rank sum and Kruskall-Wallis tests for continuous, non-nominal data and Chi-square for dichotomous variables. Odd Ratios with 95% confidence interval (CI) were also presented where applicable. Results: Of the total diabetes ketoacidosis patients, 112 (11.6 %) were cases without infection, 679 (70.2 %) bacterial infection cases and 176 (18.2 %) presumed viral infection cases. The mean white blood count (WBC) for all the patients was 18,177 ± 9,431 while 721 (74.6 %) had leukocytosis, defined by WBC ≥ 15,000/mm3. WBC differential, leukocytosis, as well as sex and body temperature were not significant predictors (p >.05) of bacterial infection. There was, however, a significant difference (p 57 years showed a higher rate of infection. Conclusion: The study shows that CLL fractions contain variety of amino acids which could promote wound healing, as well as major and minor elemental ions which, as essential body electrolytes, are required for various metabolic processes in the body.