Comparing patient characteristics and outcomes in type 1 versus type 2 diabetes with diabetic ketoacidosis: a review and a propensity-matched nationwide analysis

J Investig Med. 2021 Aug;69(6):1196-1200. doi: 10.1136/jim-2021-001901. Epub 2021 May 10.

Abstract

Diabetic ketoacidosis (DKA) is a known complication of patients with type 1 diabetes mellitus (T1DM), but less common in type 2 diabetes mellitus (T2DM). The aim of this study was to compare the outcomes of patients admitted to the hospital with DKA in T1DM versus T2DM. This was a population-based, retrospective, cohort study using data from the Nationwide Inpatient Sample. The group of patients hospitalized for DKA was divided based on a secondary diagnosis of either T1DM or T2DM. The primary outcome was inpatient mortality, and the secondary outcomes were rate of complications, length of hospital stay (LOS) and total hospital charge (THC). The inpatient mortality for DKA was 0.27% (650 patients). In T2DM, the adjusted OR (aOR) for mortality was 2.13 (95% CI 1.38 to 3.28, p=0.001) with adjusted increase in mean THC of $6035 (95% CI 4420 to 7652, p<0.001) and mean LOS of 0.5 day (95% CI 0.3 to 0.6, p<0.001) compared with T1DM. Patients with T2DM had significantly higher odds of having septic shock (aOR 2.02, 95% CI 1.160 to 3.524, p=0.013) compared with T1DM. T2DM was associated with higher inpatient mortality, septic shock and increase in healthcare utilization costs compared with T1DM.

Keywords: diabetes complications; diabetes mellitus; endocrinology.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 2* / complications
  • Diabetic Ketoacidosis* / complications
  • Diabetic Ketoacidosis* / epidemiology
  • Hospital Costs
  • Hospital Mortality
  • Humans
  • Length of Stay
  • Retrospective Studies
  • Shock, Septic