- Among adults with type 1 diabetes (T1D), factors increasing risk for diabetic ketoacidosis (DKA, serum pH
Why this matters
- DKA is life-threatening, and rates have been rising.
- DKA not well-studied among adults with T1D.
- Registry data, 2000-2016, for 46,966 patients with T1D aged ≥18 years, onset at age ≥6 months, duration ≥1 year.
- Adjustments for sex, age, diabetes duration, HbA1c, treatment regimen, diabetes center, migration status.
- Funding: German Diabetes Society, German government, Boehringer Ingelheim Pharma GmbH & Co.
- Overall, 2.5 DKA-related hospital admissions/100 patient-years.
- Highest rates in patients aged 18-30 years (4.03/100 patient-years), declining with increasing age.
- Patients with migrant background (patient or parents) had significantly higher hospitalization rates vs those without (3.40 vs 2.47 per 100 patient-years; P<.05>
- Lower DKA rates with:
- diabetes duration ≤2 years or >20 years (2.03 and 1.62 per 100 patient-years, respectively, vs 5-10 years); and
- Patients ages 31-50 years on insulin pumps had lower DKA rates vs those having multiple daily injections (2.21 vs 3.12 per 100 patient-years; P<.05>
- Possible reporting biases.