Trends in hospitalization for diabetic ketoacidosis in diabetic patients in Taiwan: Analysis of national claims data, 1997-2005

Chih Ching Liu, Kai Ren Chen, Hua Fen Chen, Hsiu Li Huang, Ming Chung Ko, Chung Yi Li

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22 Citations (Scopus)

Abstract

Background/Purpose: Diabetic ketoacidosis (DKA) is a fatal complication of diabetes, and is strongly related to the quality of diabetes care. This study aimed to establish recent secular trends of incidence density (ID) of DKA in patients with diabetes in Taiwan and to explore the effects of age and sex on the risk of a DKA emergency. Methods: Using the National Health Insurance claims data, we identified annual diabetic cohorts (around 650,000 diabetic patients annually) from 1997 to 2005, and searched for possible admissions due to DKA emergencies. We performed log-linear regression analysis to assess the trend in ID of DKA and to assess the independent effects of age and sex on the risk of DKA. Results: Although the annual ID of DKA showed a slight but significant declining trend over the study period, from 6/1000 to 5/1000 person-years, the age/sex-specific analysis indicated that female patients aged ≤ 34 years showed a significantly increasing trend. Multivariate analysis revealed that calendar year and sex had significant but small independent effects on risk of DKA admission. In contrast, age was strongly associated with risk of DKA emergency. Compared with patients aged > 65 years, notably high adjusted rate ratios (ARRs) of DKA were observed in patients aged <15 years (ARR = 48.84) and 15-34 years (ARR =15.21). Conclusion: Although the overall ID of DKA linearly decreased between 1997 and 2005, significant rising trends were still observed in female diabetic patients aged < 35 years. More aggressive diabetic care programs aimed at young female patients should be considered to reduce this emergency and possibly fatal diabetic complications.

Original languageEnglish
Pages (from-to)725-734
Number of pages10
JournalJournal of the Formosan Medical Association
Volume109
Issue number10
DOIs
Publication statusPublished - 2010 Oct 1

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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