Comparison of diabetic ketoacidosis in patients with type-1 and type-2 diabetes mellitus

Leonid Barski, Roman Nevzorov, Ilana Harman-Boehm, Alan Jotkowitz, Elena Rabaev, Miri Zektser, Lior Zeller, Elena Shleyfer, Yaniv Almog

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

Background: Diabetic ketoacidosis (DKA) occurs most often in patients with type 1 diabetes, however patients with type 2 diabetes are also susceptible to DKA under stressful conditions. The aims of our study were to evaluate and compare the clinical and biochemical characteristics and outcomes of type 1 versus type 2 diabetes mellitus (DM) patients with DKA. Methods: A retrospective cohort study of adult patients hospitalized with DKA between January 1, 2003, and January 1, 2010. The clinical and biochemical characteristics of DKA patients with type-1 DM were compared with those of patients with type-2 DM. The primary outcome was in-hospital all-cause mortality. Results: The study cohort included 201 consecutive patients for whom the admission diagnosis was DKA: 166 patients (82.6%) with type-1 DM and 35 patients (17.4%) with type-2 DM. The patients with DKA and type-2 DM were significantly older than patients with type-1 DM (64.3 versus 37.3, P < 0.001). Significantly more patients with severe forms of DKA were seen in the group with type-2 DM (25.7% versus 9.0%, P = 0.018). The total in-hospital mortality rate of patients with DKA was 4.5%. The primary outcome was significantly worse in the group of patients with type-2 DM. Conclusions: DKA in patients with type-2 DM is a more severe disease with worse outcomes compared with type-1 DM. Advanced age, mechanical ventilation and bed-ridden state were independent predictors of 30-day mortality.

Original languageEnglish
Pages (from-to)326-330
Number of pages5
JournalAmerican Journal of the Medical Sciences
Volume345
Issue number4
DOIs
StatePublished - 1 Jan 2013
Externally publishedYes

Keywords

  • DKA
  • Type-1 and type-2 DM

ASJC Scopus subject areas

  • Medicine (all)

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