title: Comparison of diabetic ketoacidosis in patients with type-1 and type-2 diabetes mellitus.
abstract: BACKGROUND
  Diabetic ketoacidosis (DKA) occurs most often in patients with type 1 diabetes, however patients with type 2 diabetes are also susceptible to DKA under stressful conditions. The aims of our study were to evaluate and compare the clinical and biochemical characteristics and outcomes of type 1 versus type 2 diabetes mellitus (DM) patients with DKA.
  
  
  METHODS
  A retrospective cohort study of adult patients hospitalized with DKA between January 1, 2003, and January 1, 2010. The clinical and biochemical characteristics of DKA patients with type-1 DM were compared with those of patients with type-2 DM. The primary outcome was in-hospital all-cause mortality.
  
  
  RESULTS
  The study cohort included 201 consecutive patients for whom the admission diagnosis was DKA: 166 patients (82.6%) with type-1 DM and 35 patients (17.4%) with type-2 DM. The patients with DKA and type-2 DM were significantly older than patients with type-1 DM (64.3 versus 37.3, P < 0.001). Significantly more patients with severe forms of DKA were seen in the group with type-2 DM (25.7% versus 9.0%, P = 0.018). The total in-hospital mortality rate of patients with DKA was 4.5%. The primary outcome was significantly worse in the group of patients with type-2 DM.
  
  
  CONCLUSIONS
  DKA in patients with type-2 DM is a more severe disease with worse outcomes compared with type-1 DM. Advanced age, mechanical ventilation and bed-ridden state were independent predictors of 30-day mortality.
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel. Electronic address: lbarski@bgu.ac.il.
authors: Leonid
authors: L
authors: Barski
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Roman
authors: R
authors: Nevzorov
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Alan
authors: A
authors: Jotkowitz
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Elena
authors: E
authors: Rabaev
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Miri
authors: M
authors: Zektser
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Lior
authors: L
authors: Zeller
authors: Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Elena
authors: E
authors: Shleyfer
authors: Diabetes Unit, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Ilana
authors: I
authors: Harman-Boehm
authors: Medical Intensive Care Unit, Soroka University Medical Center, Beer-Sheva, Israel.
authors: Yaniv
authors: Y
authors: Almog
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult