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Precipitating factors

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Factors which may precipitate diabetic ketoacidosis include:

  • omission of insulin - commonest cause, failure of compliance with either insulin medication or dietary restrictions must be considered especially in adolescents
  • infections – pneumonia, sepsis
  • acute medical illnesses e.g. - myocardial infarction, stroke, pancreatitis
  • endocrine diseases - acromegaly, Cushing’s syndrome
  • stress of recent surgical procedures
  • medications e.g. - diuretics, beta-blockers, corticosteroids, antipsychotics, and/or anticonvulsants
  • psychological problems, eating disorders
  • insulin pump malfunction
  • in prepubertal girls, diabetic ketoacidosis may occur at monthly intervals; after menarche, it may occur 2 to 3 days before menstruation
  • patients with limited access to medical services

Risk factors for DKA in newly diagnosed cases include

  • younger age (<2 yr)
  • delayed diagnosis
  • lower socioeconomic status
  • countries with low prevalence of type 1 diabetes mellitus (2)

Reference:

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