Epidemiology

The true incidence of DKA is unknown.

• according to population-based studies from the USA, incidence of DKA is thought to be ranging from 4.6 to 8 episodes per 1,000 patients with diabetes
• in England, more than 11% of people with Type 1 diabetes had an episode of diabetic ketoacidosis in the years between 2004 and 2009 (1)

DKA can occur in persons of all ages:

• a study of 4,807 episodes of DKA has revealed that
  • 14 % occurred in persons older than 70 years
  • 23 % in persons 51 to 70 years of age
  • 27 % in persons 30 to 50 years of age
  • 36 % in persons younger than 30 years

Additionally, DKA was more commonly seen in females, in persons with a migration background, and in persons 11 to 15 years of age (2)

In children

• frequency of DKA at onset of type 1 diabetes inversely correlates with the regional incidence of type 1 diabetes. Frequencies range from approximately 15–70% in Europe and North America
• the SEARCH for Diabetes in Youth Study in the USA found that nearly 10% of youth with type 2 diabetes presented with DKA; however, overall, 5–25% of patients with type 2 diabetes have DKA at the time of diagnosis (2)
• the risk of DKA in established type 1 diabetes is 1–10% per patient per year (3)

Mortality rates are lower in developed countries (2-5%) than developing countries (6-24%)

• in UK, mortality is approximately 2%
• highest rate of mortality is in older adults and persons with comorbid conditions (2)

Reference:

• (1) Savage MW et al. Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis. Diabet Med. 2011;28(5):508-15
• (2) Westerberg DP. Diabetic ketoacidosis: evaluation and treatment. Am Fam Physician. 2013;87(5):337-46.
• (3) Wolfsdorf JI et al. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014;15 Suppl 20:154-79.