ArticleActa diabetologica2024
Clinical profile of patients with diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome in Japan: a multicenter retrospective cohort study.
Article in Acta diabetologica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Hyperosmolar hyperglycaemic state: a systematic review and meta-analysis.BMJ open diabetes research & care · 2026Pooled it
- Severity and Clinical Outcomes Among ICU Patients With Diabetic Ketoacidosis: An Analysis of the Japanese Intensive Care Patient Database.Critical care explorations · 2026Observational
- Life-threatening acute complications persist among individuals with type 1 diabetes in Japan: A nationwide registry-based cross-sectional study.Journal of diabetes investigation · 2026Article
- Clinical features and outcomes of hyperglycemic hyperosmolar syndrome: a retrospective study at a Japanese university hospital.Diabetology international · 2025Article
- Factors associated with intensive care unit admission due to diabetic ketoacidosis in adults: a validated predictive model.Acta diabetologica · 2025Observational
- Article
- Chronic treatment with SGLT-2 inhibitors is associated with ICU admission and disease severity in patients with diabetic ketoacidosis: a propensity score-matched cohort study.Internal and emergency medicine · 2025Article
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Authors and funding
30 authors at 20 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDiabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS) are life-threatening complications of diabetes mellitus. Their clinical profiles have not been fully investigated.
methodsA multicenter retrospective cohort study was conducted in 21 acute care hospitals in Japan. Patients included were adults aged 18 or older who had been hospitalized from January 1, 2012, to December 31, 2016 due to DKA or HHS. The data were extracted from patient medical records. A four-group comparison (mild DKA, moderate DKA, severe DKA, and HHS) was performed to evaluate outcomes.
resultsA total of 771 patients including 545 patients with DKA and 226 patients with HHS were identified during the study period. The major precipitating factors of disease episodes were poor medication compliance, infectious diseases, and excessive drinking of sugar-sweetened beverages. The median hospital stay was 16 days [IQR 10-26 days]. The intensive care unit (ICU) admission rate was 44.4% (mean) and the rate at each hospital ranged from 0 to 100%. The in-hospital mortality rate was 2.8% in patients with DKA and 7.1% in the HHS group. No significant difference in mortality was seen among the three DKA groups.
conclusionsThe mortality rate of patients with DKA in Japan is similar to other studies, while that of HHS was lower. The ICU admission rate varied among institutions. There was no significant association between the severity of DKA and mortality in the study population.
trial registrationThis study is registered in the UMIN clinical Trial Registration System (UMIN000025393, Registered 23th December 2016).
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