Epidemiological characteristics of ketoacidosis among Korean diabetic patients

Abstract

An epidemiological study on diabetic ketoacidosis (DKA) was done by analysis of 207 cases collected from the medical records of 6 major general hospitals in Seoul area during the period of 5 years between 1979 and 1984. There was female predominance in the occurrence of DKA (male/female ratio, 0.71) in spite of the male predominance in general prevalence of diabetes mellitus (1.80). This female predominance in DKA was most striking in the age group under 40. There was a significant seasonal variation in the occurrence of DKA. DKA occurred most frequently in colder season with the highest peak in December. In July and August, the hottest season in Korea, not even a single case of DKA was recorded in this series. No discernible precipitating factor was found in 39.3% of DKA cases and infections was present as a cause of DKA in 30% of cases. In 27.5%, DKA was the first clinical presentation of diabetes and in the remainders of cases, diabetes was known to be present for average of 6.4 years. Mortality of DKA was 13.2% in this series. As to the socioeconomic status, the education level, the style of living and the duration of diabetes, there were not ascertainable differences between the DKA cases and other diabetic cases. The prospective epidemiological study of diabetic population in Korea, especially in female group, would be necessary for elucidation of the characteristics of DKA in Koreans such as the female predominance and the seasonal difference of the occurrence.

The Occurrence of Diabetic Ketoacidosis in Adults.

“…The proportion of adult DKAthat occurrs in previously undiagnosed patients ranges from 7. 1 to 27.5% (2,13,14). In our study, 22.7% of DKAepisodes (32 patients) occurred in patients without prior history of DM.Westphal (2) demonstrated that 9 of 37 patients with DKA-onset diabetes whowere followed for at least 12 months could be managed without insulin.…”

Hyperglycaemic crisis in the Eastern Cape province of South Africa: High mortality and association of hyperosmolar ketoacidosis with a new diagnosis of diabetes

“…12 SAMJ Diabetic hyperglycaemic crisis is a major reason for high-care unit admissions, 1 with mortality rates of up to 30%. [2][3][4][5][6][7][8][9] It is characteristically classified as ketoacidotic or hyperosmolar. 10 Presentations with the combination of ketoacidosis and hyperosmolality are recognised, 6,7,[11][12][13][14][15][16] and have variably been described as ketoacidosis with hyperosmolality or hyperosmolar state with ketoacidosis, depending on whether ketoacidosis or hyperosmolality was considered dominant.…”

Seasonal Variation of HbA1c in Intensive Treatment of Children with Type 1 Diabetes

“…We have seen an increase of severe hypoglycaemia in the spring and early summer in intensively treated children 16 . Diabetic ketoacidosis has been reported to occur more frequently in the winter 17 .…”