Endocrine Abstracts

Background: Diabetic ketoacidosis (DKA) is a complication of Diabetes Mellitus and is a life-threatening medical emergency usually requiring admission to an intensive care unit. There is no established guideline regarding timing of initiation of oral/enteral feeding in DKA patients.

Purpose: To determine if there is a difference in clinical outcomes for DKA patients whose oral/enteral feeding was started early vs patients whose feeding was started beyond 24 hours.

Methods: A 10-year retrospective observational cohort was conducted in a single medical center. Subjects consisted of DKA patients admitted in the Intensive Care Unit. Clinical outcomes were compared among DKA patients who were fed within 24 hours of admission (early feeding) vs those fed beyond 24 hours (late feeding). Primary outcome was DKA resolution. Secondary outcomes were Anion gap closure, Length of hospital stay, Length of ICU stay, and inpatient Mortality.

Results: A total of 68 patients were included in the study – 39 in the early feeding group and 29 in the late feeding group. Baseline characteristics, classification of Diabetes, DKA severity, and complications were comparable among the two groups. The odds of early DKA resolution or resolution of DKA within 24H was 4.8x higher in early feeding group compared to the late feeding group (95% C.I.: 1.2 – 19.6). Time to DKA resolution, time to anion gap closure, and length of hospital stay were also significantly shorter for the early feeding group. There was no significant difference in the ICU length of stay and inpatient mortality between the two groups. The power of the study is 87.34%.

Conclusion: DKA patients benefit from early feeding because it significantly shortens time to DKA resolution and anion gap closure, also length of hospital stay, without significant increase in the rate of DKA complications. Early feeding is also associated with DKA resolution within 24 hours.