Observational studyBMJ open diabetes research & care2021
Incidence and determinants of hypophosphatemia in diabetic ketoacidosis: an observational study.
Observational study in BMJ open diabetes research & care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 33 citations in OpenAlex.
- Acute kidney injury in children and adolescents with diabetic ketoacidosis managed with aggressive initial volume resuscitation.Clinics (Sao Paulo, Brazil) · 2026Article
- Hypophosphatemia in Diabetic Ketoacidosis During Intensive Care Admission.Medical sciences (Basel, Switzerland) · 2026Article
- The Diagnostic Challenges of Acute Myocarditis in a Patient with Fulminant Type 1 Diabetes and Transient Elevation of Anti-GAD Antibodies-A Case Report.Journal of clinical medicine · 2026Article
- Optimized renal protection with combined thymoquinone and glycine treatment: synergistic management of streptozotocin-induced nephropathy.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- The Prevalence of Hypophosphatemia and its Associated Risk Factors in Diabetic Ketoacidosis Patients.Journal of the ASEAN Federation of Endocrine Societies · 2025Article
- Research Priorities for Diabetic Ketoacidosis: An Evidence and Gap Mapping Review.Medical sciences (Basel, Switzerland) · 2025Review
- Electrolyte Imbalances and Metabolic Emergencies in Obesity: Mechanisms and Clinical Implications.Diseases (Basel, Switzerland) · 2025Review
- Serum Phosphorus and Hypophosphatemia During Therapy of Diabetic Ketoacidosis in Children: Single-Center, Retrospective Cohort 2016-2022.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025Article
- Phosphate Homeostasis and Disorders of Phosphate Metabolism.Current pediatric reviews · 2024Review
- Mild Hypophosphatemia-Associated Conditions in Children: The Need for a Comprehensive Approach.International journal of molecular sciences · 2022Article
- Treosulfan-induced myalgia in pediatric hematopoietic stem cell transplantation identified by an electronic health record text mining tool.Scientific reports · 2021Article
- Phosphate and fibroblast growth factor 23 in diabetes.Clinical science (London, England : 1979) · 2021Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDiabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM) characterized by hyperglycemia and metabolic acidosis. Hypophosphatemia in DKA often occurs during hospital admittance for DKA. Literature on the magnitude, determinants and consequences of hypophosphatemia in DKA is scarce. Primary aim of this study was to investigate the incidence and consequences of hypophosphatemia during hospitalisation for DKA. RESEARCH DESIGN AND
methodsCohort study among individuals with T1DM who were admitted for DKA between 2005 and 2020 in an academic and a non-academic hospital. Multivariate regression models were performed to investigate determinants of the lowest phosphate during the treatment of DKA.
resultsA total of 127 episodes of DKA among 80 individuals were identified. Age at DKA presentation was 28 (22-46) years, 45% of the cases was female, diabetes duration was 13.2 (8.9-25.5) years with glycosylated hemoglobin levels of 91.9±26.2 mmol/mol. In 9% of all cases, DKA was the first presentation of T1DM. Lowest phosphate levelss reported during the treatment phase were 0.54 (0.32-0.83) mmol/L and hypophosphatemia was present in 74% (62/84). The time to lowest phosphate was 16 (8-23) hours. In multivariate analysis, baseline bicarbonate and hemoglobin at admission were significantly associated with the lowest phosphate level reported. No adverse effects of hypophosphatemia on hospital stay duration, morbidity or mortality were found, even if left untreated.
conclusionsHypophosphatemia during DKA is common and increases with severe acidosis. However, in this study it was not related to adverse outcomes. Although limitations of this retrospective study should be taken into account, the routine and repeated measurement of phosphate levels in DKA could be reconsidered, provided that possible symptoms related to hypophosphatemia are monitored.
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