Rhabdomyolysis in diabetic ketoacidosis

Diabetic ketoacidosis is a true medical emergency. Diagnosis should be entertained and conformed within minutes of presentation. Any delay in making the diagnosis or instituting fluid and electrolyte correction is likely to increase morbidity and mortality ( Umpierrez et al ., 2004 ) .Non – traumatic RM due to diabetic decompensation (DKA) is one of complication of DKA and is a potentially lethal disorder. Also Wang et al., 1994 have been reported that RM is not uncommonly seen in diabetic emergency hyperosmolar coma and diabetic ketoacidosis (DKA) and early diagnosis is important because of its higher mortality rate .The clinical sequelae of rhabdomyolysis include hypovolemia , hyperkalemia , metabolic acidosis , acute renal failure and disseminated intravascular coagulation (DIC) (Malinoski DJ et al., 2004) .The prognosis of rhabdomyolysis- associated ARF is relatively benign (Woodrow et al.,1995 ) .The present work was undertaken to study the possibility of occurrence of RM with diabetic ketoacidosis . Clinical and biochemical studies were carried out on 80 ketoacidotic patients 40 patients (50 %) had type 1 DM and 40 patients (50 %) had type 2 DM. Twenty apparently healthy non-diabetic subjects were included as controls for normal range of serum creatine kinase and basic laboratory parameters .The 80 ketoacidotic patients were classified into group I (DKA without RM) and group II (DKA with RM).Diabetes mellitus was diagnosed according to WHO criteria ( 1985 )and diabetic ketoacidosis was considered when the plasma glucose was more than 250 mg/dl , PH less than 7.30 , serum bicarbonate less than 18 mEq/l , serum