Clinical characteristics of diabetic ketoacidosis in Korea over the past two decades

Aims  The aim of this study was to investigate changes in the clinical characteristics of diabetic ketoacidosis (DKA) in Korea over the last two decades. Methods  A retrospective medical record review of all episodes of DKA from 1982 to 2002 in four University-affiliated urban hospitals in Korea was performed. A total of 255 episodes of DKA (217 patients) were identified and divided into three consecutive 7-year periods to compare trends over time. Clinical characteristics including precipitating factors and hospital mortality were analyzed. Results  A dramatic increase in DKA admissions has occurred over the last two decades, accompanied by a marked increase in admissions of diabetic patients. The clinical characteristics of DKA remained constant over the observation period. Non-compliance to treatment was the most common precipitating factor of DKA. A total of 30 patients died in hospital (11.8% of all episodes). Older age and infection appeared to influence mortality. Conclusions  Our results suggest that rapidly increasing episodes of DKA in Korea, in parallel with increases in the numbers of diabetic patients, continue to be associated with significant mortality.