Prevalence, Cost, and Burden of Diabetic Ketoacidosis

Virdi, Naunihal; Poon, YL; Abaniel, Richard; Bergenstal, Richard M.

doi:10.1089/dia.2023.0149

Cited by 7 publications

(4 citation statements)

References 104 publications

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“…DKA is a life-threatening complication, primarily affecting individuals with T1DM, and poses a significant risk for morbidity and mortality. Moreover, DKA presents a substantial economic burden on individuals, healthcare systems, and payers [6]. Although more commonly observed in patients with T1DM, individuals with T2DM are also at risk, especially during stressful circumstances such as trauma, surgery, or infections [6][7].…”

Section: Discussionmentioning

confidence: 99%

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Unmasking Type 1 Diabetes in Adults: Insights From Two Cases Revealing Misdiagnosis As Type 2 Diabetes, With Emphasis on Autoimmunity and Continuous Glucose Monitoring

Manov¹,

Chauhan²,

Dhillon³

et al. 2023

Cureus

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Type 1 diabetes mellitus (T1DM) is often misdiagnosed as type 2 diabetes mellitus (T2DM) in adults, resulting in inadequate treatment and poor disease management. In this report, we present two patients initially misdiagnosed with T2DM for 14 and four years, respectively, leading to complications like diabetic ketoacidosis (DKA). Reevaluation confirmed adult-onset T1DM through antibody tests. Treatment was adjusted to a basal-bolus insulin regimen with the use of continuous glucose monitoring (CGM). The correct diagnosis and CGM implementation significantly improved diabetes mellitus management. This case report emphasizes the importance of mindful diagnosis in adult patients with diabetes mellitus, considering both type 1 and type 2 differentials.

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Section: Discussionmentioning

confidence: 99%

“…Moreover, DKA presents a substantial economic burden on individuals, healthcare systems, and payers [6]. Although more commonly observed in patients with T1DM, individuals with T2DM are also at risk, especially during stressful circumstances such as trauma, surgery, or infections [6][7].…”

Section: Discussionmentioning

confidence: 99%

Unmasking Type 1 Diabetes in Adults: Insights From Two Cases Revealing Misdiagnosis As Type 2 Diabetes, With Emphasis on Autoimmunity and Continuous Glucose Monitoring

Manov¹,

Chauhan²,

Dhillon³

et al. 2023

Cureus

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“…This trend places a great burden on healthcare resources worldwide. ICU costs account for a large part of the total cost of hospitalisation, posing a great challenge to the global economy [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical nomogram prediction model to assess the risk of prolonged ICU length of stay in patients with diabetic ketoacidosis: a retrospective analysis based on the MIMIC-IV database

Shi,

Chen,

Zheng

et al. 2024

BMC Anesthesiol

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Background The duration of hospitalization, especially in the intensive care unit (ICU), for patients with diabetic ketoacidosis (DKA) is influenced by patient prognosis and treatment costs. Reducing ICU length of stay (LOS) in patients with DKA is crucial for optimising healthcare resources utilization. This study aimed to establish a nomogram prediction model to identify the risk factors influencing prolonged LOS in ICU-managed patients with DKA, which will serve as a basis for clinical treatment, healthcare safety, and quality management research. Methods In this single-centre retrospective cohort study, we performed a retrospective analysis using relevant data extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Clinical data from 669 patients with DKA requiring ICU treatment were included. Variables were selected using the Least Absolute Shrinkage and Selection Operator (LASSO) binary logistic regression model. Subsequently, the selected variables were subjected to a multifactorial logistic regression analysis to determine independent risk factors for prolonged ICU LOS in patients with DKA. A nomogram prediction model was constructed based on the identified predictors. The multivariate variables included in this nomogram prediction model were the Oxford acute severity of illness score (OASIS), Glasgow coma scale (GCS), acute kidney injury (AKI) stage, vasoactive agents, and myocardial infarction. Results The prediction model had a high predictive efficacy, with an area under the curve value of 0.870 (95% confidence interval [CI], 0.831–0.908) in the training cohort and 0.858 (95% CI, 0.799–0.916) in the validation cohort. A highly accurate predictive model was depicted in both cohorts using the Hosmer–Lemeshow (H-L) test and calibration plots. Conclusion The nomogram prediction model proposed in this study has a high clinical application value for predicting prolonged ICU LOS in patients with DKA. This model can help clinicians identify patients with DKA at risk of prolonged ICU LOS, thereby enhancing prompt intervention and improving prognosis.

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“…Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus described in patients with both type 1 and type 2 diabetes ( 1 ). The pivotal facets of acute DKA management involve the administration of intravenous fluids and insulin therapy ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of balanced crystalloids versus normal saline in patients with diabetic ketoacidosis: a meta-analysis of randomized controlled trials

Liu,

Zhang,

et al. 2024

Front. Endocrinol.

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PurposeThe optimal resuscitative fluid for patients with diabetic ketoacidosis (DKA) remains controversial. Therefore, our objective was to assess the effect of balanced crystalloids in contrast to normal saline on clinical outcomes among patients with DKA.MethodsWe searched electronic databases for randomized controlled trials comparing balanced crystalloids versus normal saline in patients with DKA, the search period was from inception through October 20th, 2023. The outcomes were the time to resolution of DKA, major adverse kidney events, post-resuscitation chloride, and incidence of hypokalemia.ResultsOur meta-analysis encompassed 11 trials, incorporating a total of 753 patients with DKA. There was no significant difference between balanced crystalloids and normal saline group for the time to resolution of DKA (MD -1.49, 95%CI -4.29 to 1.31, P=0.30, I2 = 65%), major adverse kidney events (RR 0.88, 95%CI 0.58 to 1.34, P=0.56, I2 = 0%), and incidence of hypokalemia (RR 0.80, 95%CI 0.43 to 1.46, P=0.46, I2 = 56%). However, there was a significant reduction in the post-resuscitation chloride (MD -3.16, 95%CI -5.82 to -0.49, P=0.02, I2 = 73%) among patients received balanced crystalloids.ConclusionAmong patients with DKA, the use of balanced crystalloids as compared to normal saline has no effect on the time to resolution of DKA, major adverse kidney events, and incidence of hypokalemia. However, the use of balanced crystalloids could reduce the post-resuscitation chloride.Systematic review registrationhttps://osf.io, identifier c8f3d.

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Prevalence, Cost, and Burden of Diabetic Ketoacidosis

Cited by 7 publications

References 104 publications

Unmasking Type 1 Diabetes in Adults: Insights From Two Cases Revealing Misdiagnosis As Type 2 Diabetes, With Emphasis on Autoimmunity and Continuous Glucose Monitoring

Unmasking Type 1 Diabetes in Adults: Insights From Two Cases Revealing Misdiagnosis As Type 2 Diabetes, With Emphasis on Autoimmunity and Continuous Glucose Monitoring

Clinical nomogram prediction model to assess the risk of prolonged ICU length of stay in patients with diabetic ketoacidosis: a retrospective analysis based on the MIMIC-IV database

Comparison of balanced crystalloids versus normal saline in patients with diabetic ketoacidosis: a meta-analysis of randomized controlled trials

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