Medical Minute: Comparison of DKA in Patients with Type-1 and Type-2 Diabetes Mellitus

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November 25, 2014 by dailybolusoflr

By: Ryan Circh, MD
  • 201 patients admitted with DKA
    • 83% Type-1
    • 17% Type-2
  • DKA associated with type-1: typically related to insulin (missed dose, underdosed)
  • DKA associated with type-2: precipitated by infections or stress
  • Type-2 were significantly older than type-1 (64 vs 37 years old)
  • Type-2 diabetic had higher admission glucose (646 vs 543), more often to have elevated troponin (20%  vs 4%), higher BUN (89 vs 57), and higher creatinine (1.5 vs 1.18)
  • Outcomes significantly worse in group with type-2, thought to be age related

Take home point:

  • Type-2 DKA exists, consider VBG and urine ketones to screen for DKA in these patients, especially those presenting with infections.

Ref: Barski, L., et al, Am J Med Sci 345(4):326, April 2013

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