Recurrent Diabetic Ketoacidosis Occurs in Approximately 1 in 5 Patients

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Recurrent diabetic ketoacidosis was associated with increased fragmentation of health care and increased mortality.
Recurrent diabetic ketoacidosis was associated with increased fragmentation of health care and increased mortality.

(HealthDay News) — Recurrent diabetic ketoacidosis (DKA) is common, occurring in more than 1 in 5 patients, according to a study published in Diabetes Care.

James A. Mays, MD, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues identified 3615 patients with DKA from 2006 to 2012 from 6 institutions, representing 5591 inpatient admissions for DKA. The authors examined recurrent DKA, fragmentation of care, and mortality.

 

The researchers found that 21.6% of the patients had recurrent DKA. The 211 patients with 4 or more DKAs represented 5.8% of the total DKA group, but accounted for 26.3% of the encounters. Sixteen percent of the 780 recurrent patients were hospitalized at more than 1 hospital; these patients were more likely to recur (odds ratio, 2.96). Compared with nonfragmented patients, they had 1.88-times the number of encounters. After adjustment for age, sex, insurance, race, fragmentation, and DKA visit count, the odds of death increased with age and number of DKA encounters (odds ratios, 1.06 and 1.28, respectively); only 13.65 of patients died during the study period.

"Recurrent DKA was common and associated with increased fragmentation of health care and increased mortality," the authors write. "Further research is needed on potential interventions in this unique population."

Two authors disclosed financial ties to the pharmaceutical industry.

  1. Mays JA, Jackson KJ, Derby TA, et al. An evaluation of recurrent diabetic ketoacidosis, fragmentation of care, and mortality across Chicago. Diabetes Care. 2016; doi: 10.2337/dc16-0668.
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