title: Gender-related differences in clinical characteristics and outcomes in patients with diabetic ketoacidosis.
abstract: BACKGROUND
  Diabetic ketoacidosis (DKA) is 1 of the most common and serious complications of diabetes, and is a significant cause of morbidity and mortality. There is a paucity of data regarding gender-related differences in clinical characteristics and outcomes of patients hospitalized for DKA.
  
  
  OBJECTIVE
  The purpose of this study was to assess whether gender plays a role in clinical characteristics and outcome of DKA.
  
  
  METHODS
  We performed a retrospective cohort study of patients hospitalized with DKA between January 1, 2003 and January 1, 2010. The outcomes of male and female patients were compared. The primary outcome was in-hospital all-cause mortality. The secondary outcomes were 30-day all-cause mortality and rate of complications: sepsis, respiratory failure, multiple organ failure, stroke, and myocardial infarction.
  
  
  RESULTS
  Eighty-nine men and 131 women with DKA were included in the study. Male patients had higher rates of chronic renal failure compared with women (16.9% vs 3.1%; P = 0.001), whereas more women than men received oral hypoglycemic therapy (19.8% vs 9.0%; P = 0.046); women also had higher glycosated hemoglobin levels before admission (11.9% [1.7%] vs 9.9% [2.2%]; P = 0.025). The in-hospital mortality rate was not significantly different for both genders (4.5% in the male group vs 3.8% in the female group; P = 1.0). We did not find significant differences between the 2 groups in the 30-day mortality rate (4.5% vs 6.1%; P = 0.7) or the rate of complications (5.6% vs 6.9%; P = 0.9). Advanced age, mechanical ventilation, and bedridden state were independent predictors of 30-day mortality.
  
  
  CONCLUSIONS
  In our study we did not find statistically significant differences in the in-hospital mortality, 30-day all-cause mortality, or rate of complications between men and women hospitalized with DKA. However, women with poorly controlled type 2 diabetes mellitus receiving oral hypoglycemic therapy required particular attention and might benefit from earlier introduction and intensification of insulin therapy to avoid DKA.
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel. lbarski@bgu.ac.il
authors: Leonid
authors: L
authors: Barski
authors: Ilana
authors: I
authors: Harman-Boehm
authors: Roman
authors: R
authors: Nevzorov
authors: Elena
authors: E
authors: Rabaev
authors: Miri
authors: M
authors: Zektser
authors: Alan B
authors: AB
authors: Jotkowitz
authors: Lior
authors: L
authors: Zeller
authors: Elena
authors: E
authors: Shleyfer
authors: Yaniv
authors: Y
authors: Almog
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016883:Diabetic Ketoacidosis / Q000401:mortality* / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D055991:Health Records, Personal; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin