Current Clinical Features of Diabetic Ketoacidosis in Adults: A German Multicenter Study 2022–2023
Authors' conclusion
The clinical and etiological pattern of DKA is heterogeneous. Patients with pre-existing T1DM showed educational deficits concerning diagnostic and therapeutic measures to prevent DKA. Individuals with recurrent episodes of DKA require individual therapeutic concepts within the multidisciplinary diabetes care team. Emphasizing sick-day-rules in patients being treated with SGLT 2-Is is indispensable to prevent EDKA. Individuals with pre-existing T2DM represent a vulnerable group with severe comorbidities and high mortality risk due to DKA.
Study context
- Population
- Adults with diabetic ketoacidosis (DKA) leading to hospital admission, five German tertiary hospitals, 2022–2023
- Participants
- 179 adults203 DKA episodes
- Outcome
- Clinical features of DKA
Methodological detailsfive German tertiary hospitals
- Five German tertiary hospitals
Main finding
As reported in the abstract
- Cases in pre-existing T1D
- 64%
- Cases in new-onset T1D
- 14%
- Cases in pre-existing T2D
- 14%
- Cases in new-onset T2D
- 3%
- Cases in LADA
- 6%
- Cases in pancreatogenic diabetes
- 6%
- SGLT2i-associated euglycemic DKA cases
- 7
- Pre-existing T1D: DKA despite CGM
- 51%
- Pre-existing T1D: DKA despite insulin pumps or AID
- 24%
- T1D in possession of ketone test
- 21%
- T1D applying ketone testing
- 6%
- Pre-existing T1D with recurrent DKA
- 71%
- Suboptimal adherence as trigger in known T1D
- 56%
- Infections as trigger in pre-existing T2D
- 32%
Observational data: associations, not effects.
Further findings
Inpatient mortality of DKA
- Inpatient mortality risk, restricted to multimorbid patients with known T2D
- 2.3%
Original publication
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