Diabetic ketoacidosis in adults

Abstract

Shivani Misra clinical research fellow and specialist trainee year 6 in metabolic medicine 1 2 , Nick SOliver consulant diabetologist and reader in diabetes 1 3

Trends in Hospital Admission for Diabetic Ketoacidosis in Adults With Type 1 and Type 2 Diabetes in England, 1998–2013: A Retrospective Cohort Study

“…Although speculative, other reasons may be increased insulin use and increased prevalence of infection and ketosis-prone T2DM over time. Infection and noncompliance to insulin therapy are two of the most common precipitating factors for DKA (3). Whether there is an increased trend of infection in T2DM patients paralleling increased DKA trends needs future investigation.…”

Sodium‐glucose co‐transporter‐2 inhibitors and the risk of ketoacidosis in patients with type 2 diabetes mellitus: A nationwide population‐based cohort study

“…A previous study raised concerns regarding cases of euglycaemic DKA potentially associated with SGLT2 inhibitor use . DKA is a critical side effect of T2DM that can cause dehydration, hypotension, unconsciousness, cerebral oedema and death . Using claims data from the United States, a retrospective observational study showed that SGLT2 inhibitor treatment was associated with a higher risk of DKA compared with dipeptidyl peptidase‐4 (DPP‐4) inhibitor treatment; however, a meta‐analysis of 81 trials concluded that SGLT2 inhibitor prescription was not associated with DKA risk, therefore, further studies are warranted to clarify the risk of DKA associated with SGLT2 inhibitor treatment.…”

Immunological Impact of Using Insulin Pump With Typ1 Diabetes.

“…Further, the pump provides rapid acting insulin thus eliminating the need for exercise that was previously required to maintain blood sugar levels for people. The injections often provide slow acting insulin and this cannot take care of the basal rates necessary to manage after meals situations (25). The use of pumps is more convenient that using injections especially in public.…”