Increasing Hospitalizations for DKA: A Need for Prevention Programs
Year: 2018
Type: article
Abstract: Diabetic ketoacidosis (DKA) is a diabetes emergency associated with high morbidity in patients with diabetes (1). In patients with type 1 diabetes, DKA can occur at new onset of diabetes but can also recur due to lack of insulin use and precipitating causes such as infection. DKA is a hallmark of type 1 diabetes; however, DKA is increasingly recognized in patients with type 2 diabetes (2). In contrast to patients with type 1 diabetes who require life-long insulin therapy, most patients with type 2 diabetes who present with DKA can recover insulin secretion and maintain glycemic control with oral antidiabetes medications (3). While inpatient mortality rates for DKA are generally very low, <1% in the U.K. (4) and in the U.S. (5), DKA is the leading cause of mortality among children and young adults with type 1 diabetes, accounting for ∼50% of all deaths in this population (1). In addition, rates vary substantially based on health care setting; a recent analysis conducted in India reported that up to 30% of hospitalized DKA cases result in inpatient death (6).
The article by Zhong et al. (7) in this issue of Diabetes Care examines temporal trends of DKA according to the diagnosis of type 1 and type 2 diabetes between the years 1998 and 2013 in the U.K. This report used the Clinical Practice Research Datalink and the Hospital Episode Statistics databases. Overall, the authors found that hospitalizations for DKA increased in the U.K. for patients with both type 1 and type 2 diabetes. Most cases of DKA were associated with type 1 diabetes, but one in five cases of DKA were associated with a patient history of type 2 diabetes. For patients with type 1 diabetes, DKA admissions increased from 1998 to 2007 and then the rate stabilized from 2007 …
Source: Diabetes Care
DOI: 10.2337/dci18-0004
Institution: Emory University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2888447341