Incidence of diabetic ketoacidosis (DKA) is rising in both type 1 and type 2 diabetes, and those who experience an episode face a significant risk of recurrence, according to research presented at the 19th International Conference on Advanced Technologies and Treatments for Diabetes (ATTD) in Barcelona. This increase in DKA cases is a concerning trend for public health, as the condition can be life-threatening if left untreated.
Several studies from the United Kingdom, France, and the United States highlight a growing problem: insufficient early detection of rising ketone levels, both among individuals with diabetes and in routine clinical practice. Researchers warn this lack of detection may be contributing to more DKA episodes, a serious metabolic complication that can develop rapidly.
Study of Nearly 660,000 Confirms Rising Cases
One of the most comprehensive analyses reviewed data from almost 660,000 people with diabetes in the UK over a 23-year period. This large population cohort provides valuable insight into the trends of DKA.
The results showed a notable increase in incidence for both types of diabetes. In people with type 1 diabetes, the incidence of DKA tripled during the study period. The increase was even more pronounced in type 2 diabetes, with incidence multiplying by six, despite the complication traditionally being associated with type 1 diabetes.
The study also revealed a high rate of recurrence. 31.5% of people with type 1 diabetes who experienced a DKA episode had another episode later on. For those with type 2 diabetes, recurrence was observed in 12.1% of patients.
Researchers also identified certain groups at higher risk, including young adults, women, and people living in socioeconomically disadvantaged areas.
Knowledge of DKA High, But Ketone Measurement Low
Another study examined the situation in France, focusing on 553 adults with type 1 diabetes. The findings revealed a paradox: while knowledge about DKA is high, measuring ketone levels remains infrequent.
95% of participants reported having heard of ketosis, and 91% were familiar with diabetic ketoacidosis. However, 38% stated they had never measured their ketone levels.
Researchers attribute this gap between knowledge and action to factors including difficulty recognizing early symptoms, the burden of diabetes management, and a lack of systematic recommendations for ketone measurement.
This was observed even among individuals using advanced diabetes technologies, such as continuous glucose monitoring systems or automated insulin delivery devices.
Variability in Clinical Practice
A third study, based on interviews with endocrinologists and primary care physicians in the United States, found significant variability in how ketone monitoring is taught and practiced.
Even among specialists routinely treating DKA, there isn’t a consistent approach to when ketones should be measured or how results should be interpreted.
Key issues identified included a lack of standardized guidelines, incomplete ketone records, and an overreliance on glucose levels to detect potential complications. Experts emphasize that glucose levels don’t always reflect ketone accumulation, which can rise before clear signs of hyperglycemia appear.
The Necessitate for Earlier Ketone Detection
Diabetic ketoacidosis occurs when ketones accumulate in the blood to dangerous levels. It can develop quickly and, in some cases, before symptoms are recognized.
DKA is also a leading cause of death in people under 58 years old with type 1 diabetes.
While current diabetes management technologies have improved glucose monitoring, specialists stress the need to improve early detection of rising ketones. Effective management of DKA requires prompt intervention to prevent serious health consequences.
Researchers conclude that advancing access to ketone monitoring methods and establishing clearer clinical guidelines are crucial to preventing DKA episodes before they become medical emergencies.
Data presented at the 19th International Conference on Advanced Technologies and Treatments for Diabetes (ATTD)
