Table 1.
Comparison of diabetic ketoacidosis in patients on established chronic insulin therapy (I) vs. not on chronic insulin therapy (NI)
| I diabetes (n = 6209) | NI diabetes (n = 2344) | P value | |
|---|---|---|---|
| Age (years) | 36.68 (17.35) | 44.89 (19.61) | <0.0001 |
| APACHE II score | 39 (27–54) | 45 (31–61) | <0.0001 |
| Weight (kg) | 69.34 (18.26) | 76.75 (23.66) | <0.0001 |
| Chronic respiratory disease | 1 % (90) | 2 % (41) | 0.31 |
| Chronic cardiovascular disease | 3 % (188) | 4 % (87) | 0.11 |
| Chronic liver disease | 0 % (30) | 2 % (36) | <0.0001 |
| Chronic renal failure | 3 % (169) | 3 % (60) | 0.68 |
| Immune disease | 0 % (29) | 1 % (27) | 0.0005 |
| Immunosuppressed by therapy | 1 % (54) | 2 % (49) | <0.0001 |
| Metastases | 0.3 % (20) | 1.4 % (32) | <0.0001 |
| Leukaemia | 0.1 % (7) | 0.5 % (11) | 0.001 |
| Cardiac arrest in the previous 24 hours | 1 % (37) | 1 % (14) | 0.99 |
| Physiological derangement | |||
| Mean arterial pressure (mmHg) | 87.56 (22.93) | 89.74 (24.37) | 0.0001 |
| Mechanical ventilation in first 24 hours | 6 % (385) | 9 % (204) | <0.0001 |
| Glasgow Coma Score | 14.16 (2.17) | 13.96 (2.43) | 0.0002 |
| Acute renal failure | 5 % (292) | 7 % (162) | <0.0001 |
| 24 hour urine output (mL) | 2468 (1500–3700} | 2505 (1590–3800) | 0.003 |
| Laboratory derangements | |||
| Arterial pH | 7.24 (7.12–7.32) | 7.27 (7.16–7.36) | <0.0001 |
| Arterial PCO2 (mmHg) | 29 (23–35) | 31 (24–38) | <0.0001 |
| Bicarbonate (mmol/L) | 13.82 (6.73) | 15.56 (7.57) | <0.0001 |
| Standard base excess (mEq/L) | −14.51 (8.43) | −12.07 (9.27) | <0.0001 |
| PaO2 (mmHg) | 104.2 (59.88) | 106.38 (63.9) | 0.2 |
| Sodium (mmol/L) | 137.88 (7.25) | 139.22 (9.68) | <0.0001 |
| Potassium (mmol/L) | 4.4 (3.6–5) | 4.2 (3.4–4.8) | <0.0001 |
| Urea (mmol/L) | 6.8 (4.3–11.6) | 7.6 (4.5–14.8) | <0.0001 |
| Creatinine (μmol/l) | 91 (55–136) | 100 (65–152) | <0.0001 |
| Albumin (mmol/L) | 31.16 (6.8) | 30.43 (6.73) | <0.0001 |
| Bilirubin (mmol/L) | 8 (5–14) | 8 (5–13) | 0.96 |
| Highest glucose (mmol/L) | 23.5 (13.07) | 24.29 (14.35) | 0.015 |
| Lowest glucose (mmol/L) | 7.1 (5.2–10) | 8 (5.6–11.7) | <0.0001 |
| Outcomes | |||
| ICU mortalitya | 0.6 % (34) | 1.1 % (26) | 0.006 |
| Hospital mortality | 1.1 % (67) | 2.4 % (56) | <0.0001 |
| ICU length of stay (hours) | 41.6 (24–64.2) | 46.5 (26.8–73.7) | <0.0001 |
| Hospital length of stay (days) | 3.75 (2.39–6.74) | 5.12 (3.03–9.65) | <0.0001 |
Values represent worst recorded in first 24 hours of ICU admission unless stated
aDeaths during the initial admission to ICU
APACHE Acute Physiology and Chronic Health Evaluation, ICU Intensive care unit
Figures in brackets indicate actual numbers or range or SD as appropriate