Diabetes
Lakshmi Rengarajan , Emma Ooi 1 , Katrina Nash 2 , Eka Melson 3,4 , Lucretia Thomas 2 , Agnes Johnson 2 , Dengyi Zhou 2 , Lucy Wallett 3 , Sandip Ghosh 3 , Parth Narendran 3,5 & Punith Kempegowda 3,4
University Hospitals Birmingham NHS Foundation Trust; [email protected]; 1RCSI & UCD Malaysia Campus, Penang, Malaysia; 2College of Medical and Dental Sciences, University of Birmingham, UK; 3University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 4Institute of Metabolism and Systems Research, University of Birmingham, UK; 5Institute of Immunology and Immunotherapy, University of Birmingham, UK
Background: Diabetic ketoacidosis (DKA) is an acute endocrine emergency in people with diabetes. Paucity of information prevails over sex- and age-related variations in patients presenting with DKA.
Objective: To assess the impact of age and sex in the clinical course, presentation, outcome and management of DKA in people with type 1 (T1DM) and type 2 diabetes (T2DM).
Methods: We included all DKA from April 2014 to September 2020 in a large tertiary care centre in the UK. Data on patient demographics, type of diabetes, DKA duration, length of hospital stay, metabolic parameters on presentation, Insulin requirements and complications during treatment were collected. Further subgroup analyses on presentation, management, complications, and outcome parameters were repeated in subgroups according to sex (male and female) and age groups (<20, 20-29, 30-39, 40-49, 50-59, 60-60, 70-79, >80).
Results: 583 (75.9%) T1DM and 185 (24.1%) T2DM episodes were identified. The median age was 38.2 years (IQR 23.8-56.8) and the male: female ratio was 1:1.04. T2DM were older (T1DM 29.0 years (21.9-48.7) vs T2DM 61.5 years (52.0-75.1); P<0.0001). Men with T1DM had higher blood glucose at presentation (T1DM 28.7 mmol/l (22.2-37.3) vs T2DM 24.9 mmol/l (18.0-34.9) P=0.0388) whilst women with T1DM had more episodes of hypoglycaemia (T1DM 0.0 (0.0-1.0) vs T2DM 0.0 (0.0-0.0); p P=0.0195) during DKA treatment. Women with type 2 diabetes had higher urea and serum osmolality on presentation (8.8 (5.8-14.5) ;316.2 (302.67-329.95)). No other differences in metabolic parameters in other age groups were observed and no difference in the DKA duration was noted between the two groups across age and sex.
Conclusions: While there are some differences in presentation and severity across age and sex, there were no differences in DKA duration suggesting the current management guidelines can be applied across all these groups.
Volume 75
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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