Recurrent Diabetic Ketoacidosis in two Community Teaching Hospitals.
Endocr Pract. 2013 Jun 11;:1-15
Authors: Lohiya S, Kreisberg R, Lohiya V
Objective: To identify the factors that influence recurrent (1 or more previous episodes) diabetic ketoacidosis (DKA), which we refer to as recurrent DKA, in two private community teaching hospitals.Methods: Retrospective chart review of the demographics, diabetes treatment regimens, diabetes education, medical co-morbidities, medical insurance status, mental illness/psychosocial factors in 80 patients with recurrent DKA who were admitted to the resident teaching services at two Birmingham, Alabama community teaching hospitals; Trinity Medical Center (TMC) and Princeton Baptist Medical Center (PBMC), between May 2006 and May 2012.Results: The average number of admissions for recurrent DKA was 2.5 per patient. Eighty four percent of the episodes of recurrent DKA were due to omission of insulin; 44% reported omission of insulin because of illness and 40% stopped insulin for unknown reasons. Medical illnesses, including infection, accounted for only 31% of recurrent DKA admissions.Conclusion: Omission of insulin is the major cause of recurrent DKA. Psychosocial and socioeconomic factors contribute to poor adherence to therapy. Identifying these factors and instituting appropriate interventions have the potential to reduce recurrent DKA.
PMID: 23757621 [PubMed - as supplied by publisher]