ECE2022 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (318 abstracts)
Precipitating factors of diabetic ketoacidosis
Nino Matas 1,1 , Anja Barač Nekić 1 , Antonela Čović 2 , Fran Vrandečić 3 , Tatjana Bačun 4 , Ivan Feldi 5 , Darko Kaštelan 3 , Tina Dušek 3 , Karin Zibar Tomšić 3 & Anela Novak 2
1Ulica Doktor Roka Mišetića, Internal Medicine, Dubrovnik, Croatia; 2Spinčićeva Ulica, Split, Croatia; 3Kišpatićeva Ulica, Zagreb, Croatia; 4Ul. Bana Jelačića 10, Našice, Croatia; 5Ulica Josipa Huttlera, Osijek, Croatia
Introduction: Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus (DM). In some studies, infections have been shown to be a precipitating factor in half of the subjects. On the other hand, several recent studies emphasise that poor treatment adherence is also a common cause of DKA.
Objective: To identify the most common precipitating factors for DKA in the Republic of Croatia.
Patients and Methods: This retrospective, multicentre study included DM type 1 or DM type 2 patients diagnosed with DKA between January 1, 2014, and December 31, 2018, and treated in 5 different DM treatment centres: Dubrovnik, Našice, Split, Zagreb, and Osijek. Only the first episode of DKA was included in the analysis. Patients suffering from steroid DM and DM due to endocrine disorders such as acromegaly and Cushing’s syndrome were excluded.
Results: The study included 160 patients (55% men), 68% of whom had DM type 1. The median age of the respondents was 42 years (18-89). The most common cause of DKA was infection (57%), followed by poorly controlled DM (37%) and first presentation of DM (10%), while in 6% of patients DKA was due to other causes such as insulin pump failure, stroke or myocardial infarction. In the group of patients with infections, urinary tract infections (30%), gastrointestinal infections (30%), and respiratory tract infections (19%) were the most common, while 21% of patients had other sources of infection. In 39% of these patients, previously poorly controlled diabetes was present along with the infection, and in 12% of them, DKA caused by the infection was the first manifestation of the disease. In patients with DM type 2, infections were more frequently the cause of DKA than in patients with DM type 1 (P 0.05). In patients with DM type 1, poorly regulated glycemia is obviously more often the cause of DKA (31.2%) than in patients with DM type 2 (17.7%).
Conclusion: The most common precipitating factors for the development of DKA are infections and poor diabetes management, likely due to lack of patient cooperation with insulin treatment and inadequate education about the use of insulin therapy in acute illness.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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