Hyperglycemic crisis, including diabetic ketoacidosis and hyperglycemic hyperosmolar state, is a life-threatening but preventable complication of diabetes. Despite national decreases in rates of hyperglycemic crisis and other diabetes complications, recent U.S. surveillance system reports raise concern about a potential stagnation of improvements in complication rates. We assembled 2000-2015 data from CDC’s National Vital Statistics System to examine trends in hyperglycemic crisis mortality. We calculated rates as the number of deaths due to hyperglycemic crisis using the .0 and .1 E10-E14 ICD-10 codes as the underlying cause of death, divided by the U.S. civilian, noninstitutionalized population with diagnosed diabetes estimated from the National Health Interview Survey. The age-adjusted rate of hyperglycemic crisis deaths among people with diabetes declined from 2000 to 2009 (Figure) but from 2009 to 2015 increased 54.1%, from 15.7 to 24.2 per 100,000 persons with diabetes (p=.005). This reversal in trend was apparent in the 0-44 year age group (68.3% increase); males (76.9% increase) and females (39.5% increase); and blacks (34.7% increase) and whites (60.8% increase), but not among those aged 45 and older. The increase in hyperglycemic crisis mortality rates in the young population is concerning. Identification of factors contributing to the increase may help target efforts to prevent this complication.


S.R. Benoit: None. I.A. Hora: None. Y. Zhang: None. E. Gregg: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.