PT  - JOURNAL ARTICLE
AU  - Emma Ooi
AU  - Katrina Nash
AU  - Lakshmi Rengarajan
AU  - Eka Melson
AU  - Lucretia Thomas
AU  - Agnes Johnson
AU  - Dengyi Zhou
AU  - Lucy Wallett
AU  - Sandip Ghosh
AU  - Parth Narendran
AU  - Punith Kempegowda
TI  - Clinical and biochemical profile of 786 sequential episodes of diabetic ketoacidosis in adults with type 1 and type 2 diabetes mellitus
AID  - 10.1136/bmjdrc-2021-002451
DP  - 2021 Dec 01
TA  - BMJ Open Diabetes Research & Care
PG  - e002451
VI  - 9
IP  - 2
4099  - http://drc.bmj.com/content/9/2/e002451.short
4100  - http://drc.bmj.com/content/9/2/e002451.full
SO  - BMJ Open Diab Res Care2021 Dec 01; 9
AB  - Introduction We explored the clinical and biochemical differences in demographics, presentation and management of diabetic ketoacidosis (DKA) in adults with type 1 and type 2 diabetes.Research design and methods This observational study included all episodes of DKA from April 2014 to September 2020 in a UK tertiary care hospital. Data were collected on diabetes type, demographics, biochemical and clinical features at presentation, and DKA management.Results From 786 consecutive DKA, 583 (75.9%) type 1 diabetes and 185 (24.1%) type 2 diabetes episodes were included in the final analysis. Those with type 2 diabetes were older and had more ethnic minority representation than those with type 1 diabetes. Intercurrent illness (39.8%) and suboptimal compliance (26.8%) were the two most common precipitating causes of DKA in both cohorts. Severity of DKA as assessed by pH, glucose and lactate at presentation was similar in both groups. Total insulin requirements and total DKA duration were the same (type 1 diabetes 13.9 units (9.1–21.9); type 2 diabetes 13.9 units (7.7–21.1); p=0.4638). However, people with type 2 diabetes had significantly longer hospital stay (type 1 diabetes: 3.0 days (1.7–6.1); type 2 diabetes: 11.0 days (5.0–23.1); p<0.0001).Conclusions In this population, a quarter of DKA episodes occurred in people with type 2 diabetes. DKA in type 2 diabetes presents at an older age and with greater representation from ethnic minorities. However, severity of presentation and DKA duration are similar in both type 1 and type 2 diabetes, suggesting that the same clinical management protocol is equally effective. People with type 2 diabetes have longer hospital admission.Data are available upon reasonable request.