Risk factors for recurrent admissions with diabetic ketoacidosis: a case-control observational study

Area of Science:

• Endocrinology
• Metabolic Disorders
• Diabetes Mellitus Research

Background:

• Diabetic ketoacidosis (DKA) is a serious complication of Type 1 diabetes.
• Recurrent DKA admissions pose a significant burden on healthcare systems and patients.
• Identifying risk factors for DKA readmission is crucial for effective management.

Purpose of the Study:

• To analyze patients with recurrent diabetic ketoacidosis (DKA) admissions.
• To establish risk factors associated with DKA readmission in Type 1 diabetes patients.

Main Methods:

• Retrospective analysis of medical records from Auckland City Hospital (1997-2011).
• Inclusion criteria: adults and young people (>15 years) with Type 1 diabetes and a primary DKA diagnosis.
• Comparison of patients with recurrent DKA admissions versus matched controls with single admissions.

Main Results:

• A total of 268 patients accounted for 412 DKA admissions; 58 patients had multiple admissions.
• Readmission group showed more severe DKA and poorer glycemic control.
• Common factors included alcohol abuse and insulin dose omission; high clinic non-attendance in both groups.

Conclusions:

• Few distinguishing factors were identified between patients with recurrent and single DKA admissions when matched for demographics and diabetes duration.
• The limited differences present challenges in designing targeted intervention strategies to reduce DKA readmissions.