OCCURRENCE OF DIABETIC-KETOACIDOSIS IN NON-INSULIN-DEPENDENT DIABETESAND NEWLY-DIAGNOSED DIABETIC ADULTS

PURPOSE: TO examine the occurrence of diabetic ketoacidosis (DKA) in a dults without a prior history of type I diabetes. PATIENTS AND METHODS : A retrospective review was conducted of medical records of adults pr esenting with DKA between 1987 and 1993. The medical record was review ed to classify patients as type I, type II, or newly diagnosed diabeti cs and to determine the status of diabetic treatment following the epi sode 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 greater than or equal to 40 years. old. Of patie nts with follow-up of at least 12 months, about 24% of the newly diagn osed and 8% of those with a history of NIDDM were not taking insulin. CONCLUSION: DKA occurs in patients with type II diabetes. Older patien ts may present with clinically apparent type I diabetes. Some adults w ho present with DKA do not remain insulin dependent.