Diabetic ketoacidosis admissions at Middlemore Hospital: observational study of cause and patient demographics.

AIM

To analyse data on diabetic ketoacidosis (DKA) admissions to better understand characteristics of those presenting with DKA and identify high-risk groups.

METHOD

Study population consisted of people with type 1 diabetes discharged from Middlemore Hospital between 01 July 2015 and 30 June 2016 with the diagnosis of DKA. Basic demographic data and socioeconomic status as defined by 2013 New Zealand deprivation index quintiles were obtained, in addition to the cause of DKA.

RESULTS

There were 69 DKA admissions from 57 people; 35% were Pasifika and 23% Māori. Fifty-six percent were from quintile 5, the quintile with the lowest socioeconomic status. The most common cause of DKA was non-adherence to insulin (59%), followed by infection (16%) and new diagnosis of type 1 diabetes (14%). There was greater proportion of Pasifika and Māori population in those with non-adherence as the cause.

CONCLUSION

Non-adherence is a major cause of DKA admissions at Middlemore Hospital. When compared to the regional census data, there is over-representation of Pasifika and Māori population and those of lower socioeconomic status in those admitted with DKA. Similar pattern was seen in those with non-adherence as the cause of DKA and those with recurrent DKAs.