Diabetes
Catherine Cooper 1 , Amy Birchenough 2 , Lakshmi Rengarajan 3 , Ali Abdall-Razak 2 , Megan Owen 4 , Quratulain Yousuf 5 , Sungeen Khan 2 , Zachary Pierrepont 2 , Senthilkumar Krishnasamy 6 , Parijat De 7 , Parth Narendran 8 & Punith Kempegowda 9
1Foundation Doctor, Walsall Manor Hospital, Walsall, UK; [email protected]; 2Foundation Doctor, Birmingham City Hospital, Birmingham, UK; 3Junior Specialist Doctor, University Hospitals Birmingham, UK; 44 Foundation Doctor, Walsall Manor Hospital, Walsall, UK; 5Specialist Registrar, Walsall Manor Hospital, Walsall, UK; 6Consultant in Diabetes and Endocrinology, Walsall Manor Hospital, Walsall, UK; 7Consultant in diabetes and endocrinology, Sandwell and West Birmingham NHS Foundation Trust, UK; 8Consultant in Diabetes and Endocrinology, University Hospitals Birmingham, UK NHS Foundation Trust, UK; 9Wellcome Trust Clinical Research Fellow, Institute of Metabolism and Systems Research, University of Birmingham, UK
Background: Diabetic ketoacidosis (DKA) is the most common acute endocrine complication needing hospital admission. Morbidity and mortality resulting from DKA are largely preventable if we can identify and act on gaps in management in relation to current guidelines.
Objectives: To establish a common DKA registry to identify gaps in management and share best practices across centres.
Methods: All people admitted with DKA at four hospitals in the UK (named A, B, C, D for anonymity) from 1st January 2020 to 31st December 2020 were included in the study. Pseudonymised data was collected using a Google form. Comparison between hospitals was performed using the Independent-Samples Kruskal-Wallis Test.
Results: A total 341 DKA episodes were included (A-76, B-152, C-49 and D-64). Results are presented In comparison to recommendations by the Joint British Diabetes Societies Inpatient Care Group. There was no difference in administering fluids (A- median: 100.0%, B- 87.5%, C- 93.8%, D- 93.8%) and fixed-rate intravenous insulin infusion (A- 100.0%, B- 99.5, C- 100.0%, D- 96.0%) between the four hospitals. However, there were differences in glucose (A- 77.5%, B- 117.9%, C- 76.1%, D- 123.4%) and ketone monitoring (A- 10.0%, B- 56.2%, C- 10.5% , D- 14.0%). DKA duration was lower in Hospital B (A- 18.5 h, B: 11.1 h, C- 20.8 h, D- 15.0 h). However, there was no difference in the length of stay for people admitted with DKA (A- 2.9 days, B- 3.5 days, C- 3.9 days, D- 2.9 days).
Conclusion: Overall, all included hospitals have similar performance in most parameters. Certain good practices such as better glucose and ketone monitoring and reduced DKA duration were identified. We are currently meeting the stakeholders to share the results and good practices in order to make improvements and provide the best possible and uniform care for people with DKA.
Volume 75
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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