Lifetime risk and health-care burden of diabetic ketoacidosis: A population-based study

被引：13

作者：

Ebrahimi, Fahim ^{[1
,2
,3
]}

Kutz, Alexander ^{[4
,5
]}

Christ, Emanuel Remigius ^{[2
,3
]}

Szinnai, Gabor ^{[3
,6
]}

机构：

[1] St Clara Hosp & Univ Hosp, Univ Ctr Gastrointestinal & Liver Dis, Basel, Switzerland

[2] Univ Hosp Basel, Div Endocrinol Diabet & Metab, Basel, Switzerland

[3] Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland

[4] Univ Dept Med, Div Endocrinol Diabet & Metab, Aarau, Switzerland

[5] Univ Dept Med, Div Gen Internal & Emergency Med, Kantonsspital Aarau, Aarau, Switzerland

[6] Univ Basel, Univ Childrens Hosp Basel, Pediat Endocrinol & Diabetol, Basel, Switzerland

来源：

FRONTIERS IN ENDOCRINOLOGY | 2022年 / 13卷

关键词：

hyperglycemic crisis; ketoacidosis (DKA); type 1 diabetes mellitus (T1D); type 2 diabetes mellitus; coma (diabetic); YOUNG-ADULTS; STRUCTURED TRANSITION; HYPERGLYCEMIC CRISIS; TYPE-1; CHILDREN; EPIDEMIOLOGY; MORTALITY; FREQUENCY; STATEMENT; COUNTRIES;

D O I：

10.3389/fendo.2022.940990

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveDiabetic ketoacidosis (DKA) is a life-threatening complication of both type 1 and type 2 diabetes. We aimed to assess population-based rates, trends and outcomes of patients with DKA. Design and methodsThis is a nationwide cohort study using hospital discharge claims data from 2010 to 2018 in Switzerland. Incidence rates and in-hospital outcomes of DKA were analyzed throughout lifetime for children (0-9 years), adolescents (10-19 years), and adults (20-29, 30-59, and 60-90 years). Analyses were stratified for type of diabetes mellitus and sex. ResultsIn total, 5,544 hospitalizations with DKA were identified, of whom 3,847 were seen in patients with type 1 diabetes and 1,697 in type 2 diabetes. Incidence rates of DKA among patients with type 1 diabetes were highest during adolescence with 17.67 (girls) and 13.87 (boys) events per 100,000 person-years (incidence rate difference [IRD]: -3.80 [95% CI, -5.59 to -2.02]) and decreased with age in both sexes thereafter. Incidence rates of DKA in patients with type 2 diabetes were low up to an age of 40 years and rose to 5.26 (females) and 6.82 (males) per 100,000 person-years in adults aged 60-90 years. Diabetic ketoacidosis was associated with relevant health-care burden independent of age, sex, or type of diabetes. The population-based incidence rate of DKA increased over time from 7.22 per 100,000 person-years in 2010 to 9.49 per 100,000 person-years in 2018. ConclusionsIn type 1 diabetes highest incidence rates of DKA hospitalizations were observed among adolescent females. In comparison, in patients with type 2 diabetes the risk for DKA steadily increased with age with higher rates in adult males. Over the 9 year study period, incidence rates of DKA were increasing irrespective of type of diabetes. DKA was associated with a high burden of disease reflected by high rates of intensive care unit admission, prolonged hospital stay and high mortality rates, especially in elderly.

引用

页数：9

共 51 条

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