Clinical profiles, outcomes and risk factors among type 2 diabetic inpatients with diabetic ketoacidosis and hyperglycemic hyperosmolar state: a hospital-based analysis over a 6-year period

• DOI: 10.1186/s12902-020-00659-5
• Publication Date: 2020-12-14T11:04:45Z
• Authors: Xiao-yan Wu; Dun-min She; Fang Wang; Gang Guo; Ran Li; Ping Fang; Ling Li; Yun Zhou; Ke-qin Zhang; Ying Xue
• Keywords: Diabetic ketoacidosis; Ketoacidosis

Abstract Objective Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are the two most common emergencies (HEs) associated with diabetes mellitus. Individuals HEs can present combined features of DKA HHS. The objective this study is to assess clinical characteristics, therapeutic outcomes, predisposing factors type 2 diabetic patients isolated or in China. Methods We performed a retrospective analysis 158 (T2DM), complicated DKA, HHS, HHS (DKA-HHS) Shanghai Tongji Hospital, China from 2010 2015. Admission features, approaches treatment outcomes those were extracted analyzed. Results Of T2DM, 65 (41.1%) 74 (46.8%) 19 (12.0%) DKA-HHS. precipitants infections (111, 70.3%), newly diagnosed (28,17.7%) non-compliance medications (9, 5.7%). divided into mild, moderate severe group, based on arterial blood gas. Spearman correlation revealed that C-reaction protein (CRP) was positively correlated severity whereas age fasting C peptide inversely ( P < 0.05). mortality 10.8% (17/158) total 21.6% (16/74) 5.9% (1/17) indicated death effective plasma osmolality (EPO), renal function indicators hepatic enzymes, while continuous subcutaneous insulin infusion (CSII) therapy. Logistic regression suggested elevated urea nitrogen (BUN) admission an independent factor CSII might be protective for Furthermore, receiver-operating characteristic (ROC) curve BUN had largest area under ROC curves predicting Conclusions Our findings showed CRP decreased C-peptide serve as indicator DKA. Elevated predictor against