Factors associated with severe diabetic ketoacidosis in patients diagnosed with type 1 diabetes: a decade-long cross-sectional analysis

Abstract

Objective The aim of this study was to identify factors associated with severe diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in adult patients. Methods We conducted a retrospective analysis over a 10-year period including adults newly diagnosed with T1DM. Eligible participants were diagnosed with DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe. Data were collected on age, body mass index, family history of diabetes and autoimmune disorders, lifestyle habits, delayed diagnosis, and preceding factors. Results A total of 305 participants (69.8% men) with T1DM were included. Overall, 63 patients were admitted with severe DKA (Group 1) and 242 with non-severe DKA (Group 2). Factors associated with severe DKA at diagnosis of T1DM were a long period between symptom onset and first hospitalization, preceding infection, tachypnea, thrombocytopenia, anemia, hepatic cytolysis, polyuria, and tachycardia. Conclusions The present findings highlight the need for improving awareness about diabetes symptoms among physicians and the public to reduce the occurrence and severity of DKA at the onset of T1DM.