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Hospital presentations with diabetic ketoacidosis: A retrospective review
Journal article   Peer reviewed

Hospital presentations with diabetic ketoacidosis: A retrospective review

Steven James, Kylie Annetts, Thuy Frakking, Marc Broadbent, John Waugh, Lin Perry, Julia Lowe and Sean Clark
Australasian Emergency Care, Vol.26(1), pp.1-6
2023
DOI: https://doi.org/10.1016/j.auec.2022.06.001
PMID: 35817716
url
https://doi.org/10.1016/j.auec.2022.06.001View
Published Version

Abstract

Diabetes mellitus, type 1 Diabetic ketoacidosis Emergency Department Type 1 diabetes Socio-economic status
Background: Diabetic ketoacidosis (DKA) is a significant source of preventable episodes of care and cost. This study aimed to describe the demographic and clinical characteristics of people with type 1 diabetes (T1D) presenting to the Emergency Department (ED) with DKA in an area of socioeconomic deprivation in metropolitan Queensland, Australia, and to describe factors associated with hospital admission and representation in this population. Methods: This was a retrospective descriptive analysis of routine healthcare record data for January 2015-December 2019. People with T1D were identified through hospital discharge codes. Results: More than half (n = 165) the estimated local T1D population (n = 317) experienced an index ED presentation for DKA; mean ± SD age at ED presentation was 31.1 + /− 19.3 years, 126 (76.4%) were aged ≥ 16 years and 20 (12.1%) were newly diagnosed. Index DKA presentation was significantly associated with female sex (p = 0.04) but no other demographic or geographic variables. More than half the presentations (n = 92, 55.8%) occurred outside regular business hours. Twenty-three representations occurred within 90 days, associated with older age (p = 0.045) and lower residential socioeconomic score (p = 0.02). Conclusion: Findings highlight the frequent problem of DKA and the importance of socioeconomic influences. This flags the need and opportunity to improve support to people with T1D to promote diabetes self-care.

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