Francisca Victoria, NIM011411131009 (2017) PROFIL KLINIK PASIEN DENGAN KOMA DIABETIK DI RSUD DR. SOETOMO PADA TAHUN 2013-2016. Skripsi thesis, Universitas Airlangga.

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Abstract

Background: The known conditions of diabetes which may cause coma are diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS) and hypoglycemia (Shah and Joshi, 2004). This diabetic coma can be an emergency case within three hours if not resolved (Shah and Joshi, 2004). Objective: This study aims to study the profile of diabetic coma sufferers in order to improve the understanding of diabetic coma and thus improves services for patients. Method: This was a retrospective study by assessing patients’ medical record and analyzed descriptively. Result: The results obtained from 80 patients with the majority of women (62%). Diabetic coma attacks mostly at the age of 50-59 years (36%). Based on historical data, the major complaints were consciousness disturbance (31%) and loss of consciousness (31%). Patient's blood pressure results mostly (30%) was noted to show that patients suffer from first-stage hypertension, whereas on other physical examinations such as pulse and body temperature, generally obtained normal results with a percentage of 80% and 56% respectively. Respiration rate for hypoglycemic patients are mostly normal, but 97% of hyperglycemic crisis patients present high rate of respiration. In blood tests, the hemoglobin and platelet counts were predominantly normal, with percentages of 61%, and 58%, respectively, but the leukocyte levels of patients were the most abnormally high (64%). Examination of patient’s renal function in patients with post hypoglycemic coma shows that majority of patients get normal results, 62% of normal kreatinin serum and 67% of normal BUN. In the other hand, for patients with hiperglycemic crisis, mostly shows an elevated kreatinin serum and BUN, 79% and 86% each. The patient's body ion levels recorded were sodium and potassium levels, both of which were predominantly classified as normal, 49% and 51% respectively. With random blood sugar test, 37 patients (55%) with hypoglycemia showed abnormally low blood sugar outcomes, but 86% of patients with hyperglycemic crisis showed abnormally high blood sugar. Examination of blood gas analyzes records the values of blood acidity, partial pressure of oxygen and carbon dioxide, HCO3- level, base excess, and oxygen saturation. Results show a predominantly abnormal results (abnormally high for partial oxygen pressure but abnormally low for blood acidity, partial pressures of carbon dioxide, HCO3-, and base excesses). Examination of albumin content, 53% showed normal results. Most results of thorax photo (22%) showed no abnormality. With proper treatment, the majority of patients with hypoglycemia went home with improved condition, whereas most patients with hyperglycemic crisis died even after given treatments.

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