The occurrence of diabetic ketoacidosis in non-insulin-dependent diabetes and newly diagnosed diabetic adults

Purpose To examine the occurrence of diabetic ketoacidosis (DKA) in adults without a prior history of type I diabetes. Patients and Methods A retrospective review was conducted of medical records of adults presenting with DKA between 1987 and 1993. The medical record was reviewed to classify patients as type I, type II, or newly diagnosed diabetics and to determine the status of diabetic treatment following the episode of DKA in those patients without prior history of type I diabetes. Results Two hundred twenty-six patients were included in the study; 106 (47%) were classified as type I and 58 (26%) as type II from data available in the medical record, and 62 (27%) had DKA as the initial manifestation of the disease. Nineteen percent of the patients in whom diabetes was a new diagnosis and 52% of the patients who had a prior history of NIDDM were ≥40 years old. Of patients with follow-up of at least 12 months, about 24% of the newly diagnosed and 8% of those with a history of NIDDM were not taking insulin. Conclusion DKA occurs in patients with type II diabetes. Older patients may present with clinically apparent type I diabetes. Some adults who present with DKA do not remain insulin dependent.