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Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes

Karges, Beate, Rosenbauer, Joachim, Holterhus, Paul-Martin, Beyer, Peter, Seithe, Horst, Vogel, Christian, Böckmann, Andreas, Peters, Dirk, Müther, Silvia, Neu, Andreas, Holl, Reinhard W, _, _·2015·European Journal of Endocrinology

DOI 10.1530/eje-15-0129

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Abstract

Objective: To investigate rates and risk factors of hospital admission for diabetic ketoacidosis (DKA) or severe hypoglycemia in young patients with established type 1 diabetes. Design: In total, 31 330 patients with type 1 diabetes (median age 12.7 years) from the Diabetes Patienten Verlaufsdokumentation (DPV) Prospective Diabetes Registry treated between 2011 and 2013 in Germany were included. Methods: Admission rates for DKA (pH <7.3 or bicarbonate <15 mmol/l) and severe hypoglycemia (requiring assistance from another person) were calculated by negative binomial regression analysis. Associations of DKA or hypoglycemia with patient and treatment characteristics were assessed by multivariable regression analysis. Results: The mean admission rate for DKA was 4.81/100 patient-years (95% CI, 4.51–5.14). The highest DKA rates were observed in patients with HbA1c ≥9.0% (15.83 (14.44–17.36)), age 15–20 years (6.21 (5.61–6.88)) and diabetes duration of 2–4.9 years (5.60 (5.00–6.27)). DKA rate was higher in girls than in boys (5.35 (4.88–5.86) vs 4.34 (3.95–4.77), P=0.002), and more frequent in migrants than in non-migrants (5.65 (4.92–6.49) vs 4.57 (4.23–4.93), P=0.008). The mean admission rate for severe hypoglycemia was 1.45/100 patient-years (1.30–1.61). Rates were higher in migrants compared to non-migrants (2.13 (1.72–2.65) vs 1.28 (1.12–1.47), P<0.001), and highest in individuals with severe hypoglycemia within the preceding year (17.69 (15.63–20.03) vs patients without preceding hypoglycemia 0.42 (0.35–0.52), P<0.001). Differences remained significant after multivariable adjustment. Conclusions: The identification of at-risk individuals for DKA (patients with high HbA1c, longer diabetes duration, adolescents, girls) and for severe hypoglycemia (patients with preceding severe hypoglycemia, migrants) may facilitate targeted diabetes counselling in order to prevent these complications.

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Authors: Karges, B., Rosenbauer, J., Holterhus, P.-M., Beyer, P., Seithe, H., Vogel, C., Böckmann, A., Peters, D., Müther, S., Neu, A., Holl, R. W., & _, _.
Affiliations: Christian-Albrechts-Universität zu Kiel (DE)
Universität Ulm (DE)
Corresponding author: Karges, Beate
ORCID: Karges, Beate
Rosenbauer, Joachim
Holterhus, Paul-Martin
Neu, Andreas
Holl, Reinhard W
Venue: European Journal of Endocrinology
Publisher: Oxford University Press (OUP)
Published: 2015-09
Volume: 173
Issue: 3
Pages: 341-350
ISSN: 0804-4643 (ISSN-L)
1479-683X
DOI: 10.1530/eje-15-0129
OpenAlex: W1831848670
Cited by: 129
References: 20
Citations by year: 2026: 9 · 2025: 12 · 2024: 8 · 2023: 9 · 2022: 10 · 2021: 16 · 2020: 16 · 2019: 16 · 2018: 13 · 2017: 12 · 2016: 6 · 2015: 2
FWCI: 9.57
Type: journal article
Language: en
Open access: closed
Locations: European Journal of Endocrinology (publishedVersion)
PubMed (publishedVersion)
Site cant be reached (submittedVersion)
RWTH Publications (RWTH Aachen) (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Keywords: diabetic ketoacidosis, severe hypoglycemia, type 1 diabetes, young patients, hospitalization rates, risk factors, HbA1c, diabetes duration, sex differences, migrants, glycemic control, diabetes complications, Germany, children and adolescents, oral antidiabetic drugs
MeSH terms: Adolescent, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Germany, Hospitalization, Humans, Hypoglycemia, Infant, Male, Regression Analysis, Risk Factors, Severity of Illness Index, Sex Factors, Transients and Migrants, Multivariate Analysis, Diabetic Ketoacidosis, Young Adult

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Hospital admission for diabetic ketoacidosis or severe hypoglycemia in 31,330 young patients with type 1 diabetes

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