{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T05:55:55Z","timestamp":1781330155920,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the demographic, clinical, and psychosocial characteristics of individuals who died from diabetic ketoacidosis (DKA) in the community.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study of adults aged \u226518\u2009years who died from DKA in the community in Auckland, New Zealand, between January 2010 and December 2023. Cases were identified through forensic pathology records, with postmortem confirmation of DKA based on vitreous glucose &gt;10\u2009mmol\/L and beta\u2010hydroxybutyrate (BHB) \u22652.5\u2009mmol\/L. Clinical and demographic data were obtained from electronic medical records, police and coroner's reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010nine individuals met inclusion criteria. Mean age was 55\u2009\u00b1\u200916\u2009years; 61% were men. Diabetes type included type 1 (42%), type 2 (41%), pancreatogenic (2.5%), and previously undiagnosed diabetes (15%). Common features included living alone (58%), poor glycaemic control [mean HbA\n                      <jats:sub>1c<\/jats:sub>\n                      88\u2009\u00b1\u200925\u2009mmol\/mol (10.2\u2009\u00b1\u20094.4%)], socio\u2010economic deprivation, clinic non\u2010attendance, and medication non\u2010adherence (59%). Alcohol abuse and illicit drug use were 20% and 19% respectively. Among those with known diabetes, 43% had unrecognised moderate or severe coronary artery disease at autopsy. One\u2010third of individuals with type 1 diabetes had a DKA admission in the year prior to death, but few received timely follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical factors such as living in a one\u2010person household, poor glycaemic control, health care disengagement, and prior DKA admission may be associated with a higher risk of death by DKA in the community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70198","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T04:10:55Z","timestamp":1766376655000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Community deaths from diabetic ketoacidosis: A 14\u2010year retrospective study in Auckland, New Zealand"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4227-1688","authenticated-orcid":false,"given":"Rui Qian","family":"Yeu","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Greenlane Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Morrow","sequence":"additional","affiliation":[{"name":"Department of Forensic Pathology, LabPlus Auckland City Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff D.","family":"Braatvedt","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Greenlane Hospital  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2023.07.005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-022-01953-5"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/4715783"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1258"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13004"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1998.tb00655.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2018-000621"},{"key":"e_1_2_11_9_1","article-title":"Diabetic ketoacidosis admissions at Middlemore hospital: observational study of cause and patient demographics","volume":"133","author":"Heejong Lee J","year":"2020","journal-title":"N Z Med J"},{"issue":"5","key":"e_1_2_11_10_1","first-page":"153","article-title":"Recurrent diabetic ketoacidosis","volume":"63","author":"Brandstaetter E","year":"2019","journal-title":"Arch Endocrinol Metab"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2020-001329"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/19253621231167014"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.110042"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556-4029.14443"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3325\/cmj.2015.56.181"},{"key":"e_1_2_11_16_1","unstructured":"Stats NZ.Place and ethnic group summaries Auckland Region. Accessed January 15 2025.https:\/\/tools.summaries.stats.govt.nz\/places\/RC\/auckland\u2010region"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2008.12.017"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11060988"},{"key":"e_1_2_11_19_1","unstructured":"AtkinsonJ SalmondC CramptonP.NZDep2018 Index of Deprivation Interim Research Report December 2019.2019Wellington: University of Otago."},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-6646(10)60117-9"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jendso\/bvad173"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP13057.RA"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAF.0b013e31825192e7"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2019-000983"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12820"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.940990"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02065-X"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2019.01.006"},{"key":"e_1_2_11_29_1","unstructured":"Te Whatu Ora\u2014Health New Zealand.Virtual Diabetes Register: Technical Guide.2023Wellington: Te Whatu Ora."},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13506"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2023.10.010"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70198","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.70198","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:59:59Z","timestamp":1781326799000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.70198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,21]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/dme.70198"],"URL":"https:\/\/doi.org\/10.1111\/dme.70198","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,21]]},"assertion":[{"value":"2025-06-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70198"}}