Endocrine Abstracts

Diabetic ketoacidosis is a frequent and potentially life-threatening complication of diabetes. National and NICE guidelines recommend regular audit of diabetic ketoacidosis management, with emphasis on identifying and addressing precipitating factors to improve clinical outcomes and reduce recurrence. This study retrospectively reviewed all adult diabetic ketoacidosis admissions at Our Lady of Lourdes Hospital from April 2024 to April 2025. Data were collected from electronic health records, HIPE data, laboratory reports, and admission and discharge documentation. 34 patients were admitted, with an average age of 43.3 years. 70% were male. Most patients had type 1 diabetes (79%), with type 2 diabetes in 18% and Flatbush diabetes in 3%. Severity distribution was 29% severe, 44% mild, and 27% moderate diabetic ketoacidosis. Identified precipitating factors included infection (24%), missed insulin (9%), both (6%), new diabetes diagnosis (21%), and unknown causes (29%). Mean time to intravenous fluids was 69.7 minutes and to intravenous insulin was 70.3 minutes. The average length of hospital stay was 3.9 days and mean glycated haemoglobin at admission was 92 mmol/l/mol. Most patients (82%) were under endocrinology care. Diabetic ketoacidosis resolved in 94% of cases; in-hospital mortality was 6%, with all deaths unrelated to diabetic ketoacidosis. Readmission occurred in 9%. Documented outpatient compliance was 29%, with noncompliance in 44%. In conclusion, diabetic ketoacidosis most commonly affected young adults with type 1 diabetes, with infection and new diabetes diagnosis as major precipitating factors. Timely treatment achieved good outcomes, but enhanced identification of underlying causes and improved outpatient follow-up may reduce future recurrence.