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Endocrine Abstracts (2022) 81 RC5.7 | DOI: 10.1530/endoabs.81.RC5.7

1Sandwell and West Birmingham Hospitals NHS Trust, United Kingdom; 2Walsall Manor Hospital, United Kingdom; 3Good Hope Hospital, Birmingham, United Kingdom; 4University of Birmingham, United Kingdom; 5Haberdashers’ Adams’ Grammar School, United Kingdom


Introduction: Diabetes-related ketoacidosis (DKA) is an acute endocrine emergency requiring immediate diagnosis and management. Common misconception is that DKA is associated with type 1 diabetes only. We explored the proportion of people with type 2 diabetes, and compared the management, complications and outcome of DKA between people with type 1 and type 2 diabetes.

Methods: We conducted a retrospective study on people admitted with DKA across six hospitals in the United Kingdom from January to November 2021. DKA was diagnosed as serum glucose ≥11 mmol/l or known history of diabetes, ketones ≥ 3 mmol/l and pH ≤7.3 or bicarbonate ≤ 15 mmol/l. Data on demographics, use of fixed-rate insulin infusion (FRIII) and intravenous fluid infusion (IVI), blood glucose and ketone monitoring, DKA duration and length of stay were collected. We also collected data on hypoglycaemia and potassium derangement during DKA treatment.

Results: A total of 418 people admitted during this period with biochemically-proven DKA were included. 287 (68.7%) of people had type 1 diabetes; 131 (31.3%) had type 2 diabetes. There was no significant difference in duration of DKA between people with type 1 vs type 2 diabetes (13.2 hours vs 15 hours, P= 0.137), however, those with type 2 diabetes had a significantly longer length of stay (3 days vs 8 days, P=0.000). There was no significant difference in the proportion of hourly glucose (99.9% vs 98.6%, P=0.633) and ketone measurement (71.5% vs 68.6%, P=0.731), or use of FRIII (100% vs 100%, P=0.376) and IVI (100% vs 93.3%, P=0.681) There was no significant difference in the prevalence of hypoglycaemia (12.2% vs 12.2%, P=0.959), hypokalaemia (31.7% vs 36.6%, P=0.36) or hyperkalaemia (33.4% vs 36.6%, P=0.345).

Conclusions: Nearly a third of DKA cases are in people with type 2 diabetes, debunking the myth DKA is synonymous with type 1 diabetes. There was no significant difference in the complications or outcomes associated with DKA between people with type 1 vs type 2 diabetes mellitus, suggesting the current guidelines are appropriate for either type of diabetes. However, further research is needed to study if revised guidelines may result in better outcomes in DKA in type 2 diabetes. People with type 2 diabetes had significantly longer hospital stays; this finding may support earlier discharge planning and allocation of resources in those with type 2 diabetes who present with DKA.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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