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Diabet Med. 2008 Jul;25(7):867-70. doi: 10.1111/j.1464-5491.2008.02461.x.

Ketoacidosis occurs in both Type 1 and Type 2 diabetes--a population-based study from Northern Sweden.

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1
The Lundberg Laboratory for Diabetes Research, Sahlgrenska University Hospital, Göteborg, Sweden.

Abstract

AIMS:

To determine the occurrence of diabetic ketoacidosis (DKA) in adult Type 2 and Type 1 diabetic patients in Northern Sweden and to determine whether DKA presents with a different clinical picture in Type 2 compared with Type 1 diabetic subjects.

METHODS:

All adult patients from a hospital catchment area in Northern Sweden with diagnosed DKA episodes during 1997-2000 were included in a retrospective study. Medical records and laboratory reports were analysed.

RESULTS:

During the years 1997 to 2000, the average annual incidence rate for DKA was 5.9 per 100 000 adult inhabitants. Twenty-five patients developed DKA, eight (32%) had Type 2 diabetes, while 17 (68%) had Type 1 diabetes. Type 2 diabetic patients with DKA were older and had higher levels of C-peptide than Type 1 diabetic patients. On admission because of DKA, a similar degree of hyperglycaemia was present in Type 1 and Type 2 patients. Metabolic acidosis was more severe in Type 1 compared with Type 2 diabetic patients. In 50% of the Type 2 diabetic patients, diabetes was diagnosed at the episode of DKA.

CONCLUSIONS:

DKA occurs in Caucasian Type 2 diabetic patients within a Swedish population. Although the frequency of DKA is much higher in Type 1 diabetic patients, Type 2 diabetes may account for as much as one-third of the overall DKA cases.

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