A retrospective cohort study of all DKA admissions of people with type 1 diabetes at the Royal Infirmary of Edinburgh between 2007 and 2012 was conducted. Researchers cross-checked those discharged over the 6-year period with mortality data from the national Scottish Care Information–Diabetes Collaboration (SCI-Diabetes) database. Analysis of data on date of diabetes diagnosis, social deprivation status, most recent HbA1c level, length of hospital stay, laboratory results and diabetes complications was conducted. Further analysis (limited to individuals diagnosed with diabetes from 1981) investigated the influence of the number of lifetime DKA admissions.
The findings identified social deprivation as being significantly associated with an increased likelihood of recurrent (more than five) DKA presentations. Individuals in this group were diagnosed at a younger age than those with a single admission, were generally younger, had higher HbA1c levels and were more likely to use antidepressants.
Most strikingly, a greater than one in five risk of death was observed in those with the highest frequency of DKA presentation over a median 2.4 years of follow-up, representing a substantially elevated risk of death when compared with the Scottish type 1 diabetes population.
The full study can be read here.
