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Characteristics of diabetic ketoacidosis in Chinese adults and adolescents -- a teaching hospital-based analysis.
Diabetes Res Clin Pract. 2012 Aug; 97(2):306-12.DR

Abstract

OBJECTIVE

To investigate the diabetic ketoacidosis (DKA) episodes occurred in diabetic adults and adolescents.

METHODS

We reviewed diabetic patients of admissions with DKA in West China Hospital in Chengdu from January 1, 2008 to December 31, 2008. Clinical and laboratory data including β-cell function and autoantibody status were collected respectively. Patients were classified as having type 1 or type 2 diabetes or atypical diabetes based on clinical diagnosis and treatment history. And groups were compared for differences in vital statistics and biochemical profiles at presentation.

RESULTS

Detailed and accurate information was obtained in relation to 263 of patients accounted for the 287 admissions admitted for DKA, of whom 41 patients had type 1 diabetes (15.59%) meanwhile 178 patients were diagnosis as T2DM (67.68%), and 37 patients could not be "typed" were classified as atypical DM (14.07%). In addition, there were two gestational diabetes mellitus (GDM) and five patients with other specific types. Sixty admissions (22.81%) were newly diagnosed diabetes, of which 28 admissions (46.67%) were atypical diabetes. The most common contributing factor for DKA was infection (39.16%), followed by noncompliance with anti-diabetes treatment including omission of insulin (25.5%), unknown causes (25.86%) and other medical conditions (11.73%). Of note, these middle-age obese male patients with atypical diabetes often lapse into diabetic ketoacidosis without identifiable precipitating factors.

CONCLUSIONS

DKA could occur not only in T1DM but also in patients with T2DM under infection or stress condition, furthermore without any identifiable precipitant. The prevalence of DKA and its clinical heterogeneity have significant implications for diagnosing and classification of diabetes. More attention and prevention strategies are needed in ketosis-prone atypical diabetes.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041, PR China.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22704172

Citation

Tan, Huiwen, et al. "Characteristics of Diabetic Ketoacidosis in Chinese Adults and Adolescents -- a Teaching Hospital-based Analysis." Diabetes Research and Clinical Practice, vol. 97, no. 2, 2012, pp. 306-12.
Tan H, Zhou Y, Yu Y. Characteristics of diabetic ketoacidosis in Chinese adults and adolescents -- a teaching hospital-based analysis. Diabetes Res Clin Pract. 2012;97(2):306-12.
Tan, H., Zhou, Y., & Yu, Y. (2012). Characteristics of diabetic ketoacidosis in Chinese adults and adolescents -- a teaching hospital-based analysis. Diabetes Research and Clinical Practice, 97(2), 306-12. https://doi.org/10.1016/j.diabres.2012.05.004
Tan H, Zhou Y, Yu Y. Characteristics of Diabetic Ketoacidosis in Chinese Adults and Adolescents -- a Teaching Hospital-based Analysis. Diabetes Res Clin Pract. 2012;97(2):306-12. PubMed PMID: 22704172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of diabetic ketoacidosis in Chinese adults and adolescents -- a teaching hospital-based analysis. AU - Tan,Huiwen, AU - Zhou,Yunxia, AU - Yu,Yerong, Y1 - 2012/06/15/ PY - 2011/03/08/received PY - 2011/08/29/revised PY - 2012/04/24/accepted PY - 2012/6/19/entrez PY - 2012/6/19/pubmed PY - 2012/12/19/medline SP - 306 EP - 12 JF - Diabetes research and clinical practice JO - Diabetes Res Clin Pract VL - 97 IS - 2 N2 - OBJECTIVE: To investigate the diabetic ketoacidosis (DKA) episodes occurred in diabetic adults and adolescents. METHODS: We reviewed diabetic patients of admissions with DKA in West China Hospital in Chengdu from January 1, 2008 to December 31, 2008. Clinical and laboratory data including β-cell function and autoantibody status were collected respectively. Patients were classified as having type 1 or type 2 diabetes or atypical diabetes based on clinical diagnosis and treatment history. And groups were compared for differences in vital statistics and biochemical profiles at presentation. RESULTS: Detailed and accurate information was obtained in relation to 263 of patients accounted for the 287 admissions admitted for DKA, of whom 41 patients had type 1 diabetes (15.59%) meanwhile 178 patients were diagnosis as T2DM (67.68%), and 37 patients could not be "typed" were classified as atypical DM (14.07%). In addition, there were two gestational diabetes mellitus (GDM) and five patients with other specific types. Sixty admissions (22.81%) were newly diagnosed diabetes, of which 28 admissions (46.67%) were atypical diabetes. The most common contributing factor for DKA was infection (39.16%), followed by noncompliance with anti-diabetes treatment including omission of insulin (25.5%), unknown causes (25.86%) and other medical conditions (11.73%). Of note, these middle-age obese male patients with atypical diabetes often lapse into diabetic ketoacidosis without identifiable precipitating factors. CONCLUSIONS: DKA could occur not only in T1DM but also in patients with T2DM under infection or stress condition, furthermore without any identifiable precipitant. The prevalence of DKA and its clinical heterogeneity have significant implications for diagnosing and classification of diabetes. More attention and prevention strategies are needed in ketosis-prone atypical diabetes. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/22704172/Characteristics_of_diabetic_ketoacidosis_in_Chinese_adults_and_adolescents____a_teaching_hospital_based_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(12)00165-9 DB - PRIME DP - Unbound Medicine ER -