The Epidemiology of Diabetic Acidosis: A Population-Based Study

Abstract

A 12-month epidemiologic study in 1979 and 1980 of all diabetic acidosis admissions to all acute care hospitals in Rhode Island detected 152 episodes occurring in 137 persons. Eleven per cent of diabetic acidosis admissions presented in coma and the overall death-to-case ratio was 9%. Newly diagnosed diabetes accounted for 20% of these episodes, while persons having multiple episodes during the year accounted for 15% of the admissions. The annual rate of diabetic acidosis was 46 per 10,000 diabetics. Highest rates of diabetic acidosis were found for the elderly, those admitted from nursing homes and those residing in one geographic area of the state. For known diabetics with an admission for acidosis, 87% were on insulin prior to admission and 81% were nonobese. Patients seldom contacted physicians prior to admission. Insulin dose or frequency was often (40%) changed in the two weeks prior to admission. Most of the known diabetic cases of acidosis had emergency admissions for diabetes in the three-year period prior to admission and few had any structured diabetic outpatient education. Infection and noncompliance were the most frequently identified precipitants of diabetic acidosis occurring in known diabetics.

Morbidity Profile and Causes of Mortality in Type 2 Diabetes Patients: Data from a Tertiary Teaching Hospital from Eastern India

“…On the contrary, few other studies reported higher prevalences i.e. 32.5% [14] and 37.9% [15] respectively, probably due to clinic based studies.…”

Ketosis-Prone Type 2 Diabetes

“…Patients with ketosis-prone type 2 diabetes were once described as having "atypical diabetes;" however, increasing evidence indicates that this subtype of diabetes accounts for more than half of newly diagnosed black and Hispanic patients with DKA (3,6,17,42,43). These subjects are usually obese, have a strong family history of diabetes, have a low prevalence of autoimmune markers, and lack HLA genetic association (9 …”

“…DKA is reported to be responsible for Ͼ100,000 hospital admissions per year in the U.S. (1) and is present in 25-40% of children and adolescents with newly diagnosed diabetes (2) and in 4 -9% of all hospital discharge summaries among adult patients with diabetes (3,4). DKA has long been considered a key clinical feature of type 1 diabetes, an autoimmune disorder characterized by severe and irreversible insulin deficiency.…”

Arthritis care in older‐adult centers

“…For example, the evaluation of a program to reduce the frequency of diabetic ketoacidosis in a population should take into account the increased likelihood of such events during the winter months (20). Likewise, there is seasonality to public health concerns for older adults.…”