{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:12:17Z","timestamp":1792001537293,"version":"4.4.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020083","name":"Forschungsrat des Kantonsspitals Aarau","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Diabetic ketoacidosis (DKA) is a life-threatening complication of both type 1 and type 2 diabetes. We aimed to assess population-based rates, trends and outcomes of patients with DKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>This is a nationwide cohort study using hospital discharge claims data from 2010 to 2018 in Switzerland. Incidence rates and in-hospital outcomes of DKA were analyzed throughout lifetime for children (0-9 years), adolescents (10-19 years), and adults (20-29, 30-59, and 60-90 years). Analyses were stratified for type of diabetes mellitus and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 5,544 hospitalizations with DKA were identified, of whom 3,847 were seen in patients with type 1 diabetes and 1,697 in type 2 diabetes. Incidence rates of DKA among patients with type 1 diabetes were highest during adolescence with 17.67 (girls) and 13.87 (boys) events per 100,000 person-years (incidence rate difference [IRD]: -3.80 [95% CI, -5.59 to -2.02]) and decreased with age in both sexes thereafter. Incidence rates of DKA in patients with type 2 diabetes were low up to an age of 40 years and rose to 5.26 (females) and 6.82 (males) per 100,000 person-years in adults aged 60-90 years. Diabetic ketoacidosis was associated with relevant health-care burden independent of age, sex, or type of diabetes. The population-based incidence rate of DKA increased over time from 7.22 per 100,000 person-years in 2010 to 9.49 per 100,000 person-years in 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In type 1 diabetes highest incidence rates of DKA hospitalizations were observed among adolescent females. In comparison, in patients with type 2 diabetes the risk for DKA steadily increased with age with higher rates in adult males. Over the 9 year study period, incidence rates of DKA were increasing irrespective of type of diabetes. DKA was associated with a high burden of disease reflected by high rates of intensive care unit admission, prolonged hospital stay and high mortality rates, especially in elderly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2022.940990","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T05:34:49Z","timestamp":1661319289000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Lifetime risk and health-care burden of diabetic ketoacidosis: A population-based study"],"prefix":"10.3389","volume":"13","author":[{"given":"Fahim","family":"Ebrahimi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kutz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel Remigius","family":"Christ","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Szinnai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.12701","article-title":"ISPAD clinical practice consensus guidelines 2018: Diabetic ketoacidosis and the hyperglycemic hyperosmolar state","volume":"19","author":"Wolfsdorf","year":"2018","journal-title":"Pediatr Diabetes"},{"key":"B2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/s41572-020-0165-1","article-title":"Diabetic ketoacidosis","volume":"6","author":"Dhatariya","year":"2020","journal-title":"Nat Rev Dis Prim"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00293-X","article-title":"Comparison of mortality in people with type 1 and type 2 diabetes by age of diagnosis: An incident population-based study in England and Wales","volume":"10","author":"Holman","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-020-01538-0","article-title":"Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes","volume":"57","author":"Tittel","year":"2020","journal-title":"Acta Diabetol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-9032","article-title":"Hyperglycemic crises in adult patients with diabetes","volume":"32","author":"Kitabchi","year":"2009","journal-title":"Diabetes Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2174\/1573399812666160421121307","article-title":"Euglycemic diabetic ketoacidosis: A review","volume":"13","author":"Modi","year":"2016","journal-title":"Curr Diabetes Rev"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14663","article-title":"Psychosocial factors associated with repeat diabetic ketoacidosis in people living with type 1 diabetes: A systematic review","volume":"39","author":"Allcock","year":"2021","journal-title":"Diabetes Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.23471","article-title":"Sociodemographic, clinical, and treatment-related factors associated with hyperglycemic crises among adults with type 1 or type 2 diabetes in the US from 2014 to 2020","volume":"4","author":"McCoy","year":"2021","journal-title":"JAMA Netw Open"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05568-3","article-title":"The management of type 1 diabetes in adults. 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