Diabetes Ketoacidosis (DKA) has been described as a perfect storm of two main hormones working together to drive blood sugar up. This condition’s effects have the potential to be life-threatening, yet many do not understand just how common DKA is among patients with type one diabetes as well as type two diabetes.
In March 2021, Dr. Joseph Aloi, Section Chief for Endocrinology and Metabolism at Wake Forest Baptist Health, co-authored research studying the characteristics and mortality rates among hospitalized DKA patients with COVID-19. This research was published in JAMA Open Network and co-authored by Emory University School of Medicine’s Dr. Francisco Pasquel and Dr. Guillermo Umpierrez as well as Glytec’s Executive Director of Clinical Practice, Dr. Jordan Messler, and Glytec’s Founder and SVP of Research and Development, Robby Booth. The findings suggested a mortality rate six times higher for COVID-19 patients hospitalized with DKA than those without.
Utilizing de-identified data from the Glytec national database, the cohort study analyzed data from 175 hospitals located within 17 different states. Information was collected from February 1 to September 15, 2020 and analyzed between October 1, 2020 and January 14, 2021. Patients who received computerized continuous insulin infusion (CII) treatment for less than four hours were excluded. In total, 5,029 DKA patients were included in his study, and of that total 210 were COVID-19-positive, while 4,819 were not. Upon admission, glucose levels, HbA1c, potassium, sodium, bicarbonate, and anion gap were similar between both patient populations.
The results showed that 30% of DKA patients with COVID-19 died in the hospital compared to 5% of those without – a six-fold increase in mortality risk. Additionally, the overall inpatient mortality was nearly 50% for patients older than 65 years with COVID-19 and DKA. Increased mortality with COVID-19 was also observed in patients younger than 45 years and COVID-19 patients were three times more likely to experience acute kidney disease than patients that tested negative for COVID-19.
In a recent Becker’s Healthcare Podcast Dr. Aloi joined Becker’s Brian Zimmerman to discuss this research detailing the impact of DKA on hospitalized patients, and how technology can play a role in supporting treatment best practices. Throughout the interview, Dr. Aloi discusses the intersection of treating DKA and utilizing technologies such as Continuous Glucose Monitors (CGM) and an eGlycemic Management System (eGMS).
Listen to the podcast today: