Risk factors for recurrent admissions with diabetic ketoacidosis: a case–control observational study

Cooper, Howard A.; Tekiteki, Amelia; Khanolkar, Manish; Braatvedt, Geoffrey

doi:10.1111/dme.13004

Cited by 36 publications

(43 citation statements)

References 18 publications

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“…One of the most important goals of T1D treatment is to strive for blood glucose levels as normal as possible (ADA, ; Swedish National Diabetes Register, ; WHO, ). Blood glucose levels may be strongly affected by stress, anxiety and insulin treatment, for example, maintaining glycemic control at work or in school, hypoglycemia complications or keep track of needed supplies such as glucose‐testing materials or insulin (Cooper, Tekiteki, Khanolkar, & Braatvedt, ; Olshansky et al, ). In other words, self‐care is central for persons living with T1D (Helme & Grant Harrington, ; Hörnsten, Lundman, Selstam, & Sandström, ; Markowitz, Pratt, Aggarwal, Volkening, & Laffel, ; Martyn‐Nemeth, Schwarz Farabi, Mihailescu, Nemeth, & Quinn, ).…”

Section: Introductionmentioning

confidence: 99%

“…One of the most important goals of T1D treatment is to strive for blood glucose levels as normal as possible (ADA, 2018;Swedish National Diabetes Register, 2016;WHO, 2016a). Blood glucose levels may be strongly affected by stress, anxiety and insulin treatment, for example, maintaining glycemic control at work or in school, hypoglycemia complications or keep track of needed supplies such as glucose-testing materials or insulin (Cooper, Tekiteki, Khanolkar, & Braatvedt, 2016;Olshansky et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Living with type 1 diabetes as experienced by young adults

Carlsund

Söderberg

2018

Nursing Open

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Aim Describe young adults` (19–30 years) experiences of living with Type 1 Diabetes (T1D). Background Young adulthood is characterized by adaption to adult roles, gradual separation from parental support and leaving the parental home. Living with T1D in young adulthood raises challenges and concerns. Design This study has a qualitative design. Methods Semistructured interviews with 12 young adults living with T1D for 3–14 years, analysed with qualitative content analysis. Results The analysis revealed contradictory ways of handling the illness, as is illuminated in two main categories (a) and five subcategories (b). Handling the situation and dealing with different opinions (a), (b) managing daily life, emotional roller coaster and general attitudes, own views and apprehensions, ignorance and lack of motivation. Most participants were motivated, had knowledge and were in control of their long‐term illness. Planning and structure were an essential part of their daily life. The participants were anxious about losing control of their bodies, the situation, die or be a burden to other people.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Living with type 1 diabetes as experienced by young adults

Carlsund

Söderberg

2018

Nursing Open

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“…They included clinician time, diagnostic tests and intravenous medication in their calculations, reporting a mean price of £2064 per DKA admission, although their mean bed stay was longer than other published studies in this area. This cost is more than double the current UK Best Practice Tariff [18,19].…”

Section: Health Service Use and Cost Of Diabetic Ketoacidosismentioning

confidence: 96%

Recurrent diabetic ketoacidosis and a brief history of brittle diabetes research: contemporary and past evidence in diabetic ketoacidosis research including mortality, mental health and prevention

et al. 2019

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Pharmacological, technological and educational approaches have advanced the treatment of Type 1 diabetes in the last four decades and yet diabetic ketoacidosis (DKA) continues to be a leading cause of admission in Type 1 diabetes. This article begins by reviewing the contemporary epidemiological evidence in DKA. It highlights a rise in DKA episodes in the last two decades, with DKA continuing to be the leading cause of death in young people with Type 1 diabetes, and that DKA episodes are a marker for subsequent all‐cause mortality. It also summarizes the limited evidence base for DKA prevention and associations with psychopathology. To emphasize the importance of this group with high‐risk Type 1 diabetes and the degree to which they have been overlooked in the past two decades, the article summarizes the research literature of recurrent DKA during 1976–1991 when it was extensively investigated as part of the phenomenon of ‘brittle diabetes’. This period saw numerous basic science studies investigating the pathophysiology of recurrent DKA. Subsequently, research centres published their experiences of brittle diabetes research participants manipulating their treatment under research conditions. Unfortunately, the driver for this behaviour and whether it was indicative of other people with ketoacidosis was not pursued. In summary, we suggest there has been a stasis in the approach to recurrent DKA prevention, which is likely linked to historical cases of mass sabotage of brittle diabetes research. Further investigation is required to clarify possible psychological characteristics that increase the risk of DKA and thereby targets for DKA prevention.

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“…Cooper et al . suggest that, as there were no significant differences in their study in characteristics between people with recurrent admissions and those with a single admission for diabetic ketoacidosis, designing relevant intervention strategies is ‘difficult’. Ketoacidosis can be reduced by structured diabetes education , including Dose Adjustment for Normal Eating (DAFNE) , an intervention available in some parts of Auckland.…”

mentioning

confidence: 99%