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.