Endocrine Abstracts

Introduction and objectives: Diabetic ketoacidosis (DKA) is a severe acute complication of Diabetes Mellitus (DM) and as such, on a large number of occasions will require hospital admission. As we know, it happens when there is an absolute or relative insulin deficit, although it is true that the characteristics described in the literature of these episodes are very different. Our aim was to compare the characteristics of DKA occurring in patients under 25 years of age with those of patients over 25 years of age in our setting.

Material and Methods: Retrospective observational study comparing patients older than 25 years with DM admitted for DKA at San Cecilio Clinical University Hospital in Granada, Spain with those aged 16-24 years from January 1, 2019 to December 31, 2021. Variables related to the disease (type of DM, time of evolution, associated complications\..) and to the episode of DKA (precipitating factor, hospital admission time, ICU stay\..) were analyzed. Analyses were carried out with SPSS 15.0.

Results: We included 39 patients older than 25 years and 22 younger than 25 years (49% women in both groups). The time of evolution of DM was significantly shorter in patients younger than 25 years (10.86 vs 19.69 years, P < 0.05). As comorbidities, 40.5% of those older than 25 years had alterations in the psychiatric sphere (vs 14.3% of the other group, P < 0.05). Regarding previous treatment, those older than 25 years had significantly lower total slow insulin doses (22.48 vs 30.71 IU, P < 0.05). There were no significant differences in terms of need for ICU stay (59% in both groups). The most important precipitating factors in both groups were: treatment omission, dietary transgressions and concomitant infections. Metabolic control in terms of HbA1c was worse in the group under 25 years of age (11.74 vs 10.54%, P < 0.05). No significant differences were observed in analytical parameters (blood glucose, pH, HCO3 and lactic acid) at admission.

Conclusions: In our work, it was observed that admissions for DKA in our center were more frequent in patients older than 25 years, as well as that these present worse metabolic control in terms of HbA1c and higher insulin needs. On the other hand, there is a tendency for the majority of DKA episodes in patients over 25 years of age to be associated with infections, while the main risk factor in younger patients is the omission of treatment.