Incidence and outcome of adults with diabetic ketoacidosis admitted to ICUs in Australia and New Zealand

• Published in: Critical care (London, England) England), 2015-12, Vol.19 (453), p.451-451, Article 451
• Main Authors: Venkatesh, Balasubramanian, Pilcher, David, Prins, John, Bellomo, Rinaldo, Morgan, Thomas John, Bailey, Michael
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Australia - epidemiology; Care and treatment; Complications and side effects; Critical care; Diabetes; Diabetes Complications - epidemiology; Diabetes Complications - mortality; Diabetic acidosis; Diabetic ketoacidosis; Diabetic Ketoacidosis - epidemiology; Diabetic Ketoacidosis - mortality; Epidemiology; Female; Glucose; Health aspects; Hospitalization - statistics & numerical data; Hospitals; Humans; Incidence; Insulin; Insulin - administration & dosage; Intensive care; Intensive Care Units - statistics & numerical data; Ketoacidosis; Male; Metabolism; Middle Aged; Mortality; New Zealand - epidemiology; Rehabilitation; Retrospective Studies; Risk factors; Trends
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-015-1171-7

Over the last two decades, there have been several improvements in the management of diabetes. Whether this has impacted on the epidemiology and outcome of diabetic ketoacidosis (DKA) requiring intensive care unit (ICU) admission is unknown. This was a retrospective study of 8533 patients with the diagnosis of DKA admitted to 171 ICUs in Australia and New Zealand between 2000-2013 with separate independent analysis of those on established insulin (Group I) or not on insulin (Group NI) at the time of hospitalisation. Of the 8553 patients, 2344 (27%) were identified as NI. The incidence of ICU admission with DKA progressively increased fivefold from 0.97/100,000 (95% CI 0.84-1.10) in 2000 to 5.3/100,000 (95% CI 4.98-5.53) in 2013 (P