1365-P: Recurrent Diabetic Ketoacidosis—Patient Characteristics and Clinical Outcomes in Qatar

Background: Recurrent diabetic ketoacidosis (DKA) is associated with poor clinical outcomes.

Objective: We aimed to examine patients’ characteristics and clinical outcomes for patients hospitalized with recurrent DKA in Qatar.

Methods: The hospital database was interrogated for patients admitted with DKA to government hospitals in Qatar between 2015 to 2020. Precipitating cause, clinical characteristics, laboratory data, severity of DKA, complications, need for admission to the intensive care unit, length of hospital stay, time to resolution of DKA, and mortality rates were evaluated in patients with recurrent (>1 admission) compared to a single admission.

Results: A total of 1612 episodes of DKA, of which 434 patients (26.9%) had recurrent DKA, were evaluated. Compared to patients who had a single admission for DKA, those with recurrent DKA were younger [35.0 (24.0-53.0) vs 39.0 (28.0-54.0) years, p<0.001], more likely to be females (50.6% vs 37.1%, p<0.001), more likely to have type 1 diabetes (47.9% vs. 33.4%, p<0.001), a longer duration of diabetes [12.0 (5.0-19.0 vs 5.0 (0.0-13.0) years, p<0.001], more likely to have severe DKA (48.6% vs 38%, p<0.001), with a shorter time to resolution of DKA [12.5 (9.0-24.0) vs 23.0 (10.0-33.0) hours, p<0.001]. There was no difference in the precipitating cause of DKA, need for admission to the intensive care unit, hospital stay or inpatient mortality. On multivariable logistic regression analysis, significant predictors of occurrence of recurrent DKA were younger age (OR, 0.96; 95% CI, 0.95-0.98; p= 0.0001), female gender (OR, 0.63; 95% CI, 0.46-0.85; p= 0.003) and longer duration of diabetes (OR, 1.07; 95% CI, 1.04-1.09, p= 0.0001).

Conclusion: In this cohort study, recurrent DKA was associated with younger age, female predominance and longer duration of diabetes. However, hospital course and inpatient mortality rates did not differ from those with a single admission for DKA.