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Incidence of euglycaemic DKA in type 1 diabetes examined

By Editor
8th September 2019
DKA, Research

The prevalence of diabetic ketoacidosis in people with type 1 diabetes with a normal blood glucose level has been explored in a UK study.

Despite established definitions and guidelines suggesting otherwise, it has been recognised that diabetic ketoacidosis (DKA) can occur with relatively low blood glucose concentrations referred to as euglycaemic DKA (euDKA).

Leading specialist in the treatment of DKA, Professor Ketan Dhatariya, a Consultant in Diabetes, Endocrinology and General Medicine at Norfolk and Norwich University Hospitals NHS Foundation Trust, led this study published by Mayo Clinic Proceedings, working alongside trust colleague Dr James MacFarlane, ACF ST3 Diabetes and Endocrinology.

They began the investigation because of the “heightened awareness of euDKA surrounding the use of SGLT inhibitors” and also due to a lack of background data.

The researchers combined data from a UK national survey on the management of DKA undertaken in 2014 and a local survey, both completed before the widespread use of SGLT-2 inhibitors. They used different thresholds of glucose – the one recommended by JBDS, one from the American Diabetes Association, and the one used in the original reports from 1973.


Number Admission glucose <11.0 mmol/L (200 mg/dL) Admission glucose <13.9 mmol/L (250mg/dL) Admission glucose <16.7 mmol/L (300 mg/dL)
National survey (2014) 277 6 14 23
Local audit (2015) 57 4 4 6
334 10 18 29
3.0% 5.4% 8.7%

The researchers concluded: “In summary, these data should help clinicians to understand the absolute and relative risks of euDKA in those with type 1 diabetes in the current era, in particular when this diagnosis and this concern is becoming more pressing with the advent of the SGLT inhibitors that potentially increase the likelihood of developing it.”

To access the study, click here.

Picture credit: Helloquence

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