An identification of the risk factors implicated in diabetic ketoacidosis (DKA) in type 1 and type 2 diabetes mellitus

Abstract

Background

Despite improvements in therapy and disease monitoring, diabetic ketoacidosis (DKA) remains a potentially fatal consequence of diabetes. This retrospective study was undertaken to establish and identify those risk factors that are responsible for the onset of DKA.

Methods

The medical records of 77 patients from Addington Hospital, who satisfied the criteria for inclusion in the study of DKA, were reviewed (60 type 1 diabetes mellitus (DM) patients and 17 type 2 DM patients).

Results

More juveniles were admitted for multiple DKA episodes (65%) than non-juveniles (35%). DKA was present in 23% of newly diagnosed type 1 DM patients on first presentation. Infection was present in 40% of type 1 DM patients with single DKA episodes, and in 45% of type 1 DM patients with multiple DKA episodes. A total of 23.2% of all admissions for single DKA involved non-compliance with medication usage and was implicated in 32% of multiple DKA episodes. Family and/or school problems presented in 7% of single DKA episodes and in 4% in multiple DKA episodes. In the present study, the overall mortality rate was 2.5% (n=2).

Conclusions

This study showed that the most important risk factors implicated in DKA are infection, non-compliance and newly diagnosed diabetes, followed by family and/or school problems, low socio-economic status and omission of insulin.