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Global Burden of Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a critical medical emergency, with an estimated annual incidence of 4%-8% among adults with type 1 diabetes (T1D). Up to 80% of children/adolescents <15 years of age present with DKA at the time they are diagnosed with T1D. Although DKA occurs less frequently in individuals with type 2 diabetes, there has been a rise in DKA incidence in this population due to increasing use of sodium-glucose cotransporter 2 inhibitors (SGLT-2i), in which DKA often presents with only moderately elevated glucose. This is referred to as euglycemic DKA (euDKA). While DKA is traditionally linked to T1D, it also constitutes a serious clinical concern in other diabetes phenotypes…

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 New research provides important insights into diabetic ketoacidosis

“We want to know why some patients who have DKA have increased risk of cognitive decline or diabetic kidney disease later in life, and others are fine,” said Nicole Glaser, professor and pediatric endocrinologist at UC Davis Health and senior author of the study. “We want to understand what’s responsible for that difference.”

Articles of Interest

Burden of diabetic ketoacidosis still unacceptably high, study finds

Rates were disproportionately high in children younger than five years of age, non-white racial/ethnic groups, youth without private health insurance and those with lower family income. Among youth with Type 2 diabetes, DKA was much less common and decreased over time, suggesting improved detection or earlier diagnosis of diabetes.

Current concepts and controversies in prevention and treatment of diabetic ketoacidosis in children

The prevention of DKA at diagnosis of diabetes can be achieved by an intensive community intervention and education of health care providers to raise awareness. Prevention of recurrent DKA requires continuous patient education and access to diabetes programs and telephone services.

DKA: Raising Awareness To Save Lives

Recently there have been countless stories of US children lost to a disease neither their parents nor doctors even knew they had developed—type 1 diabetes. Their early symptoms were missed or easily excused away and their more pronounced symptoms were mistaken for the flu or strep throat. By the time the true nature of their disease was discovered, their bodies, without the ability to produce insulin, had begun to burn fat for energy.

DKA’s $6.8 Billion Burden: The Clinical and Economic Impact

While CGMs and insulin pumps have reduced hospitalization by roughly 50%, the introduction of dual-analyte sensors that measure both glucose and ketones could further address gaps for high-risk groups. However, success hinges on proving their value in preventing recurrent DKA episodes and ensuring their widespread adoption. For healthcare systems and investors, the goal is clear: advance technologies that reduce costs and prevent life-threatening episodes. The stakes are high, but so are the opportunities for meaningful impact.

Recurrent Diabetic Ketoacidosis: A phenomenological case study exploring the experiences of young women with Type 1 Diabetes Mellitus

This is a lifethreatening acute complication often necessitating admission to an intensive care unit, with an increased risk of death. Despite DKA's impact on those with T1DM, the experience of developing and living through it has not yet been reported

This Is The Shocking Cost Of Type 1 Diabetes

I had to ration the little insulin I had left because I couldn’t afford it and went into DKA [diabetic ketoacidosis - a painful and life-threatening complication] three times.

Resources

Diabetes.org

DKA usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours.

American Family Physician

A diagnosis of diabetic ketoacidosis requires the patient’s plasma glucose concentration to be above 250 mg per dL (although it usually is much higher), the pH level to be less than 7.30, and the bicarbonate level to be 18 mEq per L or less. Beta-hydroxybutyrate is a better measurement of the degree of ketosis than serum ketones.

Anaesthetist.com

People still die from diabetic ketoacidosis. Poor patient education is probably the most important determinant of the incidence of the catastrophe that constitutes "DKA". In several series, only about a fifth of patients with DKA are first-time presenters with recently acquired Type I diabetes mellitus. The remainder are recognised diabetics who are either noncompliant with insulin therapy, or have serious underlying illess that precipitates DKA.

MedlinePlus

DKA is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes.