Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019

Aims. Diabetic ketoacidosis (DKA) is not well characterised in New Zealand. This study is aimed at characterising the change in epidemiology and severity of DKA from 2000 to 2019 at a tertiary hospital in the Waikato region of New Zealand. Methods. A retrospective clinical data review of all patient...

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Main Authors: Lynne Chepulis, Valentina Papa, Chunhuan Lao, Justina Wu, Cinthia Minatel Riguetto, Joanna M. McClintock, Ryan G. Paul
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2023/4715783
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author Lynne Chepulis
Valentina Papa
Chunhuan Lao
Justina Wu
Cinthia Minatel Riguetto
Joanna M. McClintock
Ryan G. Paul
author_facet Lynne Chepulis
Valentina Papa
Chunhuan Lao
Justina Wu
Cinthia Minatel Riguetto
Joanna M. McClintock
Ryan G. Paul
author_sort Lynne Chepulis
collection DOAJ
description Aims. Diabetic ketoacidosis (DKA) is not well characterised in New Zealand. This study is aimed at characterising the change in epidemiology and severity of DKA from 2000 to 2019 at a tertiary hospital in the Waikato region of New Zealand. Methods. A retrospective clinical data review of all patients admitted to Waikato District Health Board hospitals with DKA was undertaken. Characteristics and severity of DKA were assessed by type of DKA admission (diagnosed at admission, nonrecurrent, and recurrent), ethnicity, social deprivation, intensive care unit (ICU) admission, and length of hospital stay, with linear regression reporting on changes over time. Results. There were 1254 admissions for DKA (564 individual patients), two-thirds being recurrent events. Nonrecurrent DKA patients were younger, whilst recurrent admissions for DKA were associated with T1D, female gender, greater socioeconomic deprivation, and rural living (all P values < 0.01). DKA admission increased 8-fold between 2000 and 2019, mostly due to an increased number of recurrent events, particularly in Māori and female patients (P<0.001). ICU admissions increased over time (P<0.001) whilst length of hospital stay trended down (P=0.031). Conclusions. The rise in recurrent DKA is concerning, particularly in youth and indigenous Māori. Healthcare inequities need to be addressed, including adequate access to mental health support to ensure optimal outcomes for all patients with diabetes.
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spelling doaj-art-d4666839ff80485aba1bcf24f948e0622025-08-20T03:23:47ZengWileyJournal of Diabetes Research2314-67532023-01-01202310.1155/2023/4715783Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019Lynne Chepulis0Valentina Papa1Chunhuan Lao2Justina Wu3Cinthia Minatel Riguetto4Joanna M. McClintock5Ryan G. Paul6Medical Research CentreFaculty of Medical and Health SciencesMedical Research CentreWaikato Regional Diabetes ServiceWaikato Regional Diabetes ServiceWaikato Regional Diabetes ServiceMedical Research CentreAims. Diabetic ketoacidosis (DKA) is not well characterised in New Zealand. This study is aimed at characterising the change in epidemiology and severity of DKA from 2000 to 2019 at a tertiary hospital in the Waikato region of New Zealand. Methods. A retrospective clinical data review of all patients admitted to Waikato District Health Board hospitals with DKA was undertaken. Characteristics and severity of DKA were assessed by type of DKA admission (diagnosed at admission, nonrecurrent, and recurrent), ethnicity, social deprivation, intensive care unit (ICU) admission, and length of hospital stay, with linear regression reporting on changes over time. Results. There were 1254 admissions for DKA (564 individual patients), two-thirds being recurrent events. Nonrecurrent DKA patients were younger, whilst recurrent admissions for DKA were associated with T1D, female gender, greater socioeconomic deprivation, and rural living (all P values < 0.01). DKA admission increased 8-fold between 2000 and 2019, mostly due to an increased number of recurrent events, particularly in Māori and female patients (P<0.001). ICU admissions increased over time (P<0.001) whilst length of hospital stay trended down (P=0.031). Conclusions. The rise in recurrent DKA is concerning, particularly in youth and indigenous Māori. Healthcare inequities need to be addressed, including adequate access to mental health support to ensure optimal outcomes for all patients with diabetes.http://dx.doi.org/10.1155/2023/4715783
spellingShingle Lynne Chepulis
Valentina Papa
Chunhuan Lao
Justina Wu
Cinthia Minatel Riguetto
Joanna M. McClintock
Ryan G. Paul
Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019
Journal of Diabetes Research
title Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019
title_full Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019
title_fullStr Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019
title_full_unstemmed Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019
title_short Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019
title_sort epidemiology of diabetic ketoacidosis in the waikato region of new zealand 2000 2019
url http://dx.doi.org/10.1155/2023/4715783
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