Diabetes complications and comorbidities: Ketoacidosis

A major study of children from three continents suggests that diabetic ketoacidosis remains unacceptably high among those newly identified with type 1 diabetes and shows few signs of improving.

Age at type 1 diabetes diagnosis does not appear to affect glycemic control and comorbidity once disease is established, but important differences occur between age groups at the time of diagnosis, US study data show.

Chinese researchers say that some COVID-19 patients present with ketosis, which may progress to diabetic ketoacidosis in those with diabetes.

A post-hoc analysis of the DECLARE-TIMI 58 trial suggests that the sodium-glucose cotransporter-2 inhibitor dapagliflozin has a favorable safety profile in a broad population of patients with type 2 diabetes.

Secondary diabetes may carry a higher risk for diabetic ketoacidosis than type 1 diabetes does, show findings from a population-based study.

A large study backs hyperosmolarity as a key risk stratification factor for patients admitted to hospital with diabetic ketoacidosis.

A study of more than a thousand patients suggests that having both diabetic ketoacidosis and a hyperosmolar hyperglycemic state on arrival at hospital leads to more than twice the likelihood of death there than either condition alone.

Findings from the T1D Exchange clinic registry suggest a more than twofold increased risk for diabetic ketoacidosis in people who are moderate users of cannabis.

Real-world, off-label sodium–glucose cotransporter 2 inhibitor use is uncommon in people with type 1 diabetes but appears to be associated with a higher than expected rate of diabetic ketoacidosis when compared with clinical trials, US researchers report.

Implementing a nursing protocol that includes point-of-care testing at triage reduces the time to diabetic ketoacidosis diagnosis and the number of unnecessary intravenous placements in the pediatric emergency department, say researchers.

The risk for acute and chronic diabetes complications associated with poor glucose control is highest among young adults with type 1 diabetes and decreases with age even when the level of glycemic control is equally poor in the older age groups, real-world study data show.

People with type 1 diabetes who have depressive symptoms may have an increased risk for diabetic ketoacidosis as well as deteriorating glycemic control, research suggests.

Adding the SGLT1/2 inhibitor sotagliflozin to insulin treatment improves glycemic and non-glycemic outcomes among people with type 1 diabetes, but at the cost of an increased risk for diabetic ketoacidosis, researchers report in The BMJ.

Children with type 1 diabetes are more likely than their non-diabetic peers to seek primary care for a number of specific conditions in the year before their diagnosis, which could aid detection before the onset of diabetic ketoacidosis, say researchers.

Experts have developed consensus recommendations for minimizing diabetic ketoacidosis risk in patients with type 1 diabetes treated with SGLT inhibitors.

The addition of empagliflozin to insulin therapy reduces glycated hemoglobin levels in patients with type 1 diabetes, indicate findings from the phase III EASE-2 and 3 trials.

Almost half of young adults with type 1 diabetes do not see a diabetes physician for more than a year during their transition from pediatric to adult care, and this lack of contact is associated with an increased risk for complications, Canadian research shows.

Continuous subcutaneous insulin infusion therapy significantly lowers glycated hemoglobin levels in young people with type 1 diabetes, but at the cost of an increased risk for diabetic ketoacidosis during the first year, UK researchers report.

The DEPICT-2 findings confirm those of DEPICT-1, with dapagliflozin producing improved glycemic control and weight loss, and reduced insulin need, in patients with type 1 diabetes.

The DEPICT-1 and inTandem1 investigators have released their 52-week findings, revealing persistent reductions in glycated hemoglobin with SGLT2 inhibition, but a slightly increased risk for diabetic ketoacidosis.