The red blood cell distribution width–albumin ratio was a potential prognostic biomarker for diabetic ketoacidosis

Abstract

The red blood cell distribution width-to-albumin ratio (RAR %/g/dL) has emerged as a novel inflammatory biomarker, combining two well-established clinical parameters: red blood cell distribution width (RDW) and serum albumin levels. Both RDW and albumin have independently been associated with prognosis in a wide range of diseases, such as cardiovascular conditions, kidney disease, liver disease, and diabetes. The aim of this study was to explore the prognostic value of RAR in patients diagnosed with diabetic ketoacidosis (DKA), a serious complication of diabetes that requires urgent medical attention. This prospective study was conducted among 44 patients diagnosed with DKA, treated at the Department of General Medicine, Kempegowda Institute of Medical Sciences, over a period of 12 months. Data were collected on relevant laboratory investigations and radiological findings, and analyzed using SPSS (Version 26.0). Descriptive statistics, such as mean and standard deviation, were used to summarize the data, while comparisons between variables were performed using the student t-test, with statistical significance set at p < 0.05. The mean age of the study participants was 50.25 ± 15.60 years, with 47.7% being male. The average RDW-to-albumin ratio was 5.86 ± 0.8550. Among the participants, 9.1% (n=4) died during the study, and their mean RAR was higher at 6.32 ± 1.61, compared to 5.82 ± 0.762 among survivors. Although this difference was not statistically significant, a RAR cutoff value of 4.85 was identified, predicting mortality with a sensitivity of 75% and a specificity of 92.5%. These findings suggest that the RDW-to-albumin ratio may serve as a simple, cost-effective tool for predicting prognosis in DKA patients, though further research with larger cohorts is required to substantiate its utility.