Diabetic ketoacidosis as a reason for hospitalization in adult patients with any type of diabetes mellitus

Abstract

Introduction. Diabetic ketoacidosis (DKA) is an acute complication of any type of diabetes, but most commonly is associated with type 1 diabetes mellitus (T1D). This condition is a complex metabolic disorder resulting from significant relative or absolute deficiency of insulin, which still leads to excess of mortality and health care burden. The main aim of the study was to assess the direct cause of DKA and to determine population at-risk among patients with greater predisposition to develop DKA, in order to propose methods and range of their education in the future. Materials and methods. This study presents a retrospective analysis of 120 cases of DKA (102 adults with diabetes) hospitalized in the Department of Internal Medicine and Diabetology at the Central Teaching Hospital of Medical University of Lodz between 2014 and 2017. Results. 68.4% of patients with DKA were T1D and LADA, 15.0% were T2D, 5.8% presented other types of diabetes and 10.8% were de novo diabetes. The mean age was 40.5 ± 17.7 years, diabetes duration 11.1 ± 9.74 years, HbA 1c was 11.8 ± 2.54%. The main reason for hospitalization of patients for DKA was alcohol abuse (32.5%),followed by infection (23.4%), discontinuation of insulin treatment due to other reasons (13.4%), de novo diabetes (10.8%), lack of compliance (5.8%), mental disorders (5.8%) and complex causes (3.3%). In 5.0% of patients the reason could not be determined. All patients recovered, there was no death resulting of DKA. Conclusions. DKA occurs most frequently in T1D, but may be associated with type 2 or other types of diabetes. Most of our patients had a history of longterm poor control of diabetes. In many cases DKA, e.g. resulting from alcohol abuse or lack of compliance, probably can be avoided when proper patient education was given.