Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland

Elena Putula; Heini Huhtala; Sini Vanhamäki; Tiina Laatikainen; Aapo Tahkola; Päivi Hannula; Saara Metso

doi:10.1016/j.deman.2023.100129

Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland

Elena Putula^*
, Heini Huhtala
, Sini Vanhamäki
, Tiina Laatikainen
, Aapo Tahkola
, Päivi Hannula
, Saara Metso

^*Corresponding author for this work

Research output: Contribution to journal › Article › Scientific › peer-review

1 Citation (Scopus)

37 Downloads (Pure)

Abstract

Aims: To assess the prognosis and risk factors for diabetic ketoacidosis (DKA) in Tampere University Hospital (Tays) in a retrospective case-control study. Methods: All 282 patients (age ≥15 years) treated for DKA in Tays during the period 2014–2020 were included. A total of 846 controls adjusted for age, gender, diabetes type and municipality, and without any DKA during follow-up were collected from the Finnish National Diabetes Registry. HbA1c, mental and behavioural disorders, and mortality obtained from the Finnish National Diabetes Registry were compared between patients with and without DKA. Results: Patients’ median age was 36 years. Ten percent of the patients with DKA died during the median follow-up time of three years. Mortality rate was sixfold higher in patients with DKA than among the controls (OR 6.28; 95% CI 3.17–12.42). Patients with DKA had higher rates of substance abuse (OR 4.68; 95% CI 3.23–6.78) and depression (OR 2.24; 95% CI 1.58–3.18), and higher median HbA1c levels (84 vs. 61 mmol/mol, p < 0.001). Nineteen percent of the DKA patients (n = 53) had recurrent DKA. Conclusions: DKA is a strong indicator for premature death. Poor glycaemic control, depression and substance abuse are risk factors for DKA.

Original language	English
Article number	100129
Number of pages	7
Journal	Diabetes Epidemiology and Management
Volume	10
DOIs	https://doi.org/10.1016/j.deman.2023.100129
Publication status	Published - 2023
Publication type	A1 Journal article-refereed

Funding

This work was supported by a research grant from the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital ( 9AA046, 2020 ) and a grant from the Pharmaceutical Industry Research Foundation .

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Diabetes mellitus
Diabetic ketoacidosis
Glycaemic control
Insulin adherence
Psychiatric comorbidities
Substance abuse

Publication forum classification

Publication forum level 1

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism
Internal Medicine

Access to Document

10.1016/j.deman.2023.100129Licence: CC BY-NC-ND

1-s2.0-S2666970623000021-mainFinal published version, 474 KBLicence: CC BY-NC-ND

https://urn.fi/URN:NBN:fi:tuni-202305045207Licence: CC BY-NC-ND

Cite this

@article{f23703cfe48a4e159fb262d5dd5f4d5d,

title = "Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland",

abstract = "Aims: To assess the prognosis and risk factors for diabetic ketoacidosis (DKA) in Tampere University Hospital (Tays) in a retrospective case-control study. Methods: All 282 patients (age ≥15 years) treated for DKA in Tays during the period 2014–2020 were included. A total of 846 controls adjusted for age, gender, diabetes type and municipality, and without any DKA during follow-up were collected from the Finnish National Diabetes Registry. HbA1c, mental and behavioural disorders, and mortality obtained from the Finnish National Diabetes Registry were compared between patients with and without DKA. Results: Patients{\textquoteright} median age was 36 years. Ten percent of the patients with DKA died during the median follow-up time of three years. Mortality rate was sixfold higher in patients with DKA than among the controls (OR 6.28; 95\% CI 3.17–12.42). Patients with DKA had higher rates of substance abuse (OR 4.68; 95\% CI 3.23–6.78) and depression (OR 2.24; 95\% CI 1.58–3.18), and higher median HbA1c levels (84 vs. 61 mmol/mol, p < 0.001). Nineteen percent of the DKA patients (n = 53) had recurrent DKA. Conclusions: DKA is a strong indicator for premature death. Poor glycaemic control, depression and substance abuse are risk factors for DKA.",

keywords = "Diabetes mellitus, Diabetic ketoacidosis, Glycaemic control, Insulin adherence, Psychiatric comorbidities, Substance abuse",

author = "Elena Putula and Heini Huhtala and Sini Vanham{\"a}ki and Tiina Laatikainen and Aapo Tahkola and P{\"a}ivi Hannula and Saara Metso",

note = "Funding Information: This work was supported by a research grant from the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital ( 9AA046, 2020 ) and a grant from the Pharmaceutical Industry Research Foundation . Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

doi = "10.1016/j.deman.2023.100129",

language = "English",

volume = "10",

journal = "Diabetes Epidemiology and Management",

issn = "2666-9706",

publisher = "Elsevier",

}

TY - JOUR

T1 - Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland

AU - Putula, Elena

AU - Huhtala, Heini

AU - Vanhamäki, Sini

AU - Laatikainen, Tiina

AU - Tahkola, Aapo

AU - Hannula, Päivi

AU - Metso, Saara

N1 - Funding Information: This work was supported by a research grant from the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital ( 9AA046, 2020 ) and a grant from the Pharmaceutical Industry Research Foundation . Publisher Copyright: © 2023 The Author(s)

PY - 2023

Y1 - 2023

N2 - Aims: To assess the prognosis and risk factors for diabetic ketoacidosis (DKA) in Tampere University Hospital (Tays) in a retrospective case-control study. Methods: All 282 patients (age ≥15 years) treated for DKA in Tays during the period 2014–2020 were included. A total of 846 controls adjusted for age, gender, diabetes type and municipality, and without any DKA during follow-up were collected from the Finnish National Diabetes Registry. HbA1c, mental and behavioural disorders, and mortality obtained from the Finnish National Diabetes Registry were compared between patients with and without DKA. Results: Patients’ median age was 36 years. Ten percent of the patients with DKA died during the median follow-up time of three years. Mortality rate was sixfold higher in patients with DKA than among the controls (OR 6.28; 95% CI 3.17–12.42). Patients with DKA had higher rates of substance abuse (OR 4.68; 95% CI 3.23–6.78) and depression (OR 2.24; 95% CI 1.58–3.18), and higher median HbA1c levels (84 vs. 61 mmol/mol, p < 0.001). Nineteen percent of the DKA patients (n = 53) had recurrent DKA. Conclusions: DKA is a strong indicator for premature death. Poor glycaemic control, depression and substance abuse are risk factors for DKA.

AB - Aims: To assess the prognosis and risk factors for diabetic ketoacidosis (DKA) in Tampere University Hospital (Tays) in a retrospective case-control study. Methods: All 282 patients (age ≥15 years) treated for DKA in Tays during the period 2014–2020 were included. A total of 846 controls adjusted for age, gender, diabetes type and municipality, and without any DKA during follow-up were collected from the Finnish National Diabetes Registry. HbA1c, mental and behavioural disorders, and mortality obtained from the Finnish National Diabetes Registry were compared between patients with and without DKA. Results: Patients’ median age was 36 years. Ten percent of the patients with DKA died during the median follow-up time of three years. Mortality rate was sixfold higher in patients with DKA than among the controls (OR 6.28; 95% CI 3.17–12.42). Patients with DKA had higher rates of substance abuse (OR 4.68; 95% CI 3.23–6.78) and depression (OR 2.24; 95% CI 1.58–3.18), and higher median HbA1c levels (84 vs. 61 mmol/mol, p < 0.001). Nineteen percent of the DKA patients (n = 53) had recurrent DKA. Conclusions: DKA is a strong indicator for premature death. Poor glycaemic control, depression and substance abuse are risk factors for DKA.

KW - Diabetes mellitus

KW - Diabetic ketoacidosis

KW - Glycaemic control

KW - Insulin adherence

KW - Psychiatric comorbidities

KW - Substance abuse

U2 - 10.1016/j.deman.2023.100129

DO - 10.1016/j.deman.2023.100129

M3 - Article

AN - SCOPUS:85147361959

SN - 2666-9706

VL - 10

JO - Diabetes Epidemiology and Management

JF - Diabetes Epidemiology and Management

M1 - 100129

ER -

Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland

Abstract

Funding

UN SDGs

Keywords

Publication forum classification

ASJC Scopus subject areas

Access to Document

Fingerprint

Cite this