“Mind the Gap” When Managing Ketoacidosis in Type 1 Diabetes
- Paul Lee, MBBS (HONS)12,
- Jerry R. Greenfield, FRACP, PHD123 and
- Lesley V. Campbell, FRACP, FRCP123
- 1Department of Endocrinology, St. Vincent's Hospital, Sydney, New South Wales, Australia
- 2Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- 3Diabetes Centre, St. Vincent's Hospital, Sydney, New South Wales, Australia
- Corresponding author: Dr. Paul Lee, p.lee{at}garvan.org.au
Substance abuse has increased among type 1 diabetic patients (1) and can lead to life-threatening diabetic ketoacidosis (DKA). This is the first study examining the impact of substance abuse on acidosis in DKA.
A retrospective review was performed on 19 type 1 diabetic patients who presented with DKA (glucose >15 mmol/l, presence of urinary and/or plasma ketones , and pH <7.2) during a 10-month period. Of these, patients reported nonadherence to ≥1 dose of insulin before presentation. Ten patients reported illicit drug use in the 48 h before presentation, including cannabis (n = 8), ecstasy (n = 6), ketamine (n = 6), benzodiazepines (n = 3) , …
