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Rise in hospital admissions for diabetes ketoacidosis in England, research says

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DCUK NewsBot

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Hospital admissions for diabetic ketoacidosis (DKA) in England rose slightly between 1998 and 2013, research has found. DKA is a dangerous short-term complication of diabetes which occurs when blood sugar levels climb too high and the body does not have enough insulin. While it is more common in people with type 1 diabetes, those with type 2 diabetes producing limited insulin may also be affected. Symptoms of DKA, which should be regarded as a medical emergency, include dehydration, vomiting, a peardrop-like smell on the breath and confusion. Identifying signs of DKA as soon as possible is imperative in order for proper treatment to be administered. In a new study, researchers from the University of North Carolina at Chapel Hill looked at the records of 23,246 adults living with type 1 diabetes together with a further 241,441 adults who had type 2 diabetes. The data was obtained from two sources, the Clinical Practice Research Datalink and Hospital Episode Statistics. The research team identified admissions to hospital where DKA was the main reason was the visit between 1998 and 2013. The study looked for patterns in DKA admissions as well as length of hospital stay and a readmission rate after 30 days factoring in different causes and also mortality rates after both 30 days and one year. Rates of hospital admission for DKA increased between 1998-2007 in people with type 1 diabetes and then remained at the same level until 2013. The rate of DKA in people with type 2 diabetes rose by about 4% each year between 1998 and 2013. Discharge from hospital within two days occurred more often in adults with type 1 diabetes than those with type 2. The likelihood of hospital readmission within 30 days was greater for people with type 1 diabetes. Mortality rates were stable whilst the length of hospital stay decreased over the period studied for both types of diabetes. The study was published by the American Diabetes Association’s journal Diabetes Care.

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Some were saying because GPs not great at picking up the signs? Or are we becoming a culture of not bothering with drs and googling our symptoms instead?
 
My first thought was:
Has "coding" improved? Or is it a real change?
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bulkbiker said:
Quite hard for Type2's to get ketoacidosis surely?
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Recently they have been a lot more cases, maybe due to heavy drinking. The people when made stable are sent home without a need for insulin. It just does not match what the textbooks say......
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But I thought drinking lowered blood glucose?
So how do you get ketones and high blood sugar when drunk?
 
bulkbiker said:
"those with type 2 diabetes producing limited insulin may also be affected."
Surely if you are only producing limited insulin you aren't Type 2?
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Insulin can be very limited in Type2 after 10 years or so when the beta cells have all been killed off. (Hence the need to "reverse" type2 before that stage.)
 
bulkbiker said:
But I thought drinking lowered blood glucose?
So how do you get ketones and high blood sugar when drunk?
Click to expand...

I think it is with heavy long-term drinking, it may be that the BG gets so high that the beta cells stop working, but that they recover quickly once BG is lowered. There have been a few papers published on ketoacidosis in Type2, no one seems to know what is going on, but people are being sent home not need long-term insulin!
 
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