Faich G A, Fishbein H A, Ellis S E
Am J Epidemiol. 1983 May;117(5):551-8. doi: 10.1093/oxfordjournals.aje.a113577.
A 12-month epidemiologic study in 1979 and 1980 of all diabetic acidosis admissions to all acute care hospitals in Rhode Island detected 152 episodes occurring in 137 persons. Eleven per cent of diabetic acidosis admissions presented in coma and the overall death-to-case ratio was 9%. Newly diagnosed diabetes accounted for 20% of these episodes, while persons having multiple episodes during the year accounted for 15% of the admissions. The annual rate of diabetic acidosis was 46 per 10,000 diabetics. Highest rates of diabetic acidosis were found for the elderly, those admitted from nursing homes and those residing in one geographic area of the state. For known diabetics with an admission for acidosis, 87% were on insulin prior to admission and 81% were nonobese. Patients seldom contacted physicians prior to admission. Insulin dose or frequency was often (40%) changed in the two weeks prior to admission. Most of the known diabetic cases of acidosis had emergency admissions for diabetes in the three-year period prior to admission and few had any structured diabetic outpatient education. Infection and noncompliance were the most frequently identified precipitants of diabetic acidosis occurring in known diabetics.
1979年和1980年对罗德岛州所有急症医院收治的糖尿病酸中毒患者进行了为期12个月的流行病学研究，共发现137人发生了152次发病情况。11%的糖尿病酸中毒入院患者以昏迷状态就诊，总体病死率为9%。新诊断的糖尿病患者占这些发病情况的20%，而一年内多次发病的患者占入院人数的15%。糖尿病酸中毒的年发病率为每10000名糖尿病患者中有46例。糖尿病酸中毒发病率最高的是老年人、从疗养院入院的患者以及该州一个地理区域的居民。对于因酸中毒入院的已知糖尿病患者，87%在入院前使用胰岛素，81%不肥胖。患者在入院前很少联系医生。在入院前两周，胰岛素剂量或注射频率经常（40%）发生变化。大多数已知的糖尿病酸中毒病例在入院前三年因糖尿病紧急入院，很少有人接受过任何系统性的糖尿病门诊教育。感染和不遵医嘱是已知糖尿病患者发生糖尿病酸中毒最常见的诱发因素。
