Event Rates And Risk Factors For The Development Of Diabetic Ketoacidosis In Adult Patients With Type 1 Diabetes: Analysis From The Dpv Registry Based On 46,966 Patients

Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM) that results from absolute insulin deficiency and is marked by acidosis, ketosis, and hyperglycemia (1). Therefore, prevention of DKA is one goal in T1DM care, but recent data indicate increased incidence (2).For adult patients, only limited data are available on rates and risk factors for development of DKA, and this complication remains epidemiologically poorly characterized. The Diabetes Prospective Follow-up Registry (DPV) has followed patients with diabetes from 1995. Data for this study were collected from 2000 to 2016. Inclusion criteria were diagnosis of T1DM, age at diabetes onset ≥6 months, patient age at follow-up ≥18 years, and diabetes duration ≥1 year to exclude DKA at manifestation. DKA was defined as serum pH u003c7.3, and rates of DKA were analyzed based on a Poisson regression model accounting for overdisperson stratified by sex, age, diabetes duration, HbA1c, treatment regimen, size of diabetes center, and migration background, i.e., whether the patient or one or both parents were born outside the countries of the registry. A diabetes center that treated ≥50 adult patients with T1DM in the year 2016 was considered large.In total, 46,966 patients were included in this study (average age 38.5 years [median 21.2], …