open access

Vol 2, No 6 (2013)
Original articles (submitted)
Published online: 2013-12-30
Get Citation

Analysis of causative factors of diabetic ketoacidosis in adult patients with type 1 diabetes

Marzena Kapłon, Karolina Balawajder, Paweł Niedźwiecki, Aleksandra Uruska, Aleksandra Araszkiewicz, Dorota Zozulińska-Ziółkiewicz
Diabetologia Kliniczna 2013;2(6):200-207.

open access

Vol 2, No 6 (2013)
Original articles (submitted)
Published online: 2013-12-30

Abstract

Introduction. Diabetic ketoacidosis (DKA) results from absolute insulin deficiency. Delayed diagnosis or inadequate treatment of DKA may lead to coma or death. The aim of this study was to determine the exact DKA causative factors in patients with type 1 diabetes (DM1) hospitalized at the Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences.

Material and methods. We performed a retrospective analysis of medical records of 103 diabetic ketoacidosis in patients treated between November 2008 and March 2011. The analysis included only adult patients with type 1 diabetes and documented treatment of DKA. Incidence of causative factors of DKA was studied among all patients hospitalized due to DKA and inpatients with previously diagnosed DM1. Additionally, the frequency of various causes of DKA, depending on the insulin therapy regimen was established.

Results. In 47.6% of all analysed cases, DKA was caused by insulin omission, in 41.8% by infection andin 24.3% by delayed diagnosis of type 1 diabetes. Inpatients with previously diagnosed DM1, in 62.8% of cases DKA resulted from insulin omission and in 55.1% from infections. Among the patients on insulin pump therapy, 81.8% of DKA episodes developed as a result of insulin pump occlusion and 54.5% were triggered by infections. In patients on intensive insulin therapy using injecting devices (pens), 70.0% of DKA cases were caused by errors in insulin therapy and 43.3% byinfections. In 68.8% of patients using premixed insulin, precipitating factor for DKA was infection and in 56.3% — in correct insulin dosing. Recurrent DKA was associated with insulin omission in 76.2% of cases and infection in 52.4%.

Conclusion. In every fourth patient hospitalized due to diabetic ketoacidosis, metabolic disturbances were a consequence of delayed diagnosis of type 1 diabetes. In patients with previously diagnosed type 1 diabetes, the leading cause of diabetic ketoacidosis, regardless of insulin therapy regimen, were insulin omission and infections. The main cause of recurrent diabetic ketoacidosis was non-compliance with insulin therapy.

Abstract

Introduction. Diabetic ketoacidosis (DKA) results from absolute insulin deficiency. Delayed diagnosis or inadequate treatment of DKA may lead to coma or death. The aim of this study was to determine the exact DKA causative factors in patients with type 1 diabetes (DM1) hospitalized at the Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences.

Material and methods. We performed a retrospective analysis of medical records of 103 diabetic ketoacidosis in patients treated between November 2008 and March 2011. The analysis included only adult patients with type 1 diabetes and documented treatment of DKA. Incidence of causative factors of DKA was studied among all patients hospitalized due to DKA and inpatients with previously diagnosed DM1. Additionally, the frequency of various causes of DKA, depending on the insulin therapy regimen was established.

Results. In 47.6% of all analysed cases, DKA was caused by insulin omission, in 41.8% by infection andin 24.3% by delayed diagnosis of type 1 diabetes. Inpatients with previously diagnosed DM1, in 62.8% of cases DKA resulted from insulin omission and in 55.1% from infections. Among the patients on insulin pump therapy, 81.8% of DKA episodes developed as a result of insulin pump occlusion and 54.5% were triggered by infections. In patients on intensive insulin therapy using injecting devices (pens), 70.0% of DKA cases were caused by errors in insulin therapy and 43.3% byinfections. In 68.8% of patients using premixed insulin, precipitating factor for DKA was infection and in 56.3% — in correct insulin dosing. Recurrent DKA was associated with insulin omission in 76.2% of cases and infection in 52.4%.

Conclusion. In every fourth patient hospitalized due to diabetic ketoacidosis, metabolic disturbances were a consequence of delayed diagnosis of type 1 diabetes. In patients with previously diagnosed type 1 diabetes, the leading cause of diabetic ketoacidosis, regardless of insulin therapy regimen, were insulin omission and infections. The main cause of recurrent diabetic ketoacidosis was non-compliance with insulin therapy.

Get Citation

Keywords

type 1 diabetes mellitus, diabetic ketoacidosis, insulin therapy

About this article
Title

Analysis of causative factors of diabetic ketoacidosis in adult patients with type 1 diabetes

Journal

Clinical Diabetology

Issue

Vol 2, No 6 (2013)

Pages

200-207

Published online

2013-12-30

Bibliographic record

Diabetologia Kliniczna 2013;2(6):200-207.

Keywords

type 1 diabetes mellitus
diabetic ketoacidosis
insulin therapy

Authors

Marzena Kapłon
Karolina Balawajder
Paweł Niedźwiecki
Aleksandra Uruska
Aleksandra Araszkiewicz
Dorota Zozulińska-Ziółkiewicz

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl