D iabetic ketoacidosis (DKA) is an acute metabolic complication of type 1 diabetes mellitus. This study aimed to define the DKA mortality rate in a Birmingham population and to identify risk factors for mortality and repeat admissions. An evaluation of 137 patients' notes retrieved from five hospitals in and around Birmingham, UK, identified 278 admissions over a 9-year period (2000-2009). The International Classification of Disease 10 coding system for DKA, E101, was employed to identify notes. Overall five (1.8%) patients died. Mortality was significantly associated with age, presence of comorbidity and diabetic complications. Poor control and compliance, female sex, clinic non-attendance, presence of co-morbidity and psychological problems all increased the risk of recurrent DKA admissions. Our study supports a role for improving education and glycaemic control to reduce DKA and its associated mortality. Br J Diabetes Vasc Dis 2009;9:278-282

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