• Leili Gao, Yufeng Li, Dadong Fei, Li Ma, Shuchun Chen, Bo Feng, Qing Su, and Linong Ji.
• Department of Endocrine and Metabolic Diseases, Peking University People's Hospital, Beijing, China.
• J Diabetes. 2018 Mar 1; 10 (3): 249-255.

BackgroundThe aim of the present study was to investigate the prevalence of diabetic ketosis (DK) and its risk factors in Chinese diabetes patients with severe hyperglycemia.MethodsThe present multicenter cross-sectional study was performed on patients aged >16 years with diabetes mellitus (DM) and random blood glucose levels >13.9 mmol/L (>250 mg/dL). Blood ketones (β-hydroxybutyric acid) and urinary ketones (acetoacetic acid) were measured and information on patient demographic and clinical characteristics was collected.ResultsOf 1235 patients enrolled in the study (93 with type 1 DM [T1DM]), 1142 with type 2 DM [T2DM]), 242 (19.6%) had DK (blood ketone levels ≥0.6 mmol/L). Proportionately, DK was more frequent and more severe in patients with T1DM than T2DM (55.9% vs 16.6%, respectively), but in absolute terms occurred in more patients with T2DM (52 vs 190). In patients with blood ketone levels ≥3 mmol/L, the cut-off point of blood glucose levels was 19.05 mmol/L. Risk factors significantly associated with higher blood ketone levels in T2DM included younger age, a shorter duration of diabetes, and not using antidiabetic medication within 12 months prior to the hyperglycemic episode.ConclusionsThe prevalence of DK is lower in patients with T2DM than T1DM, but the number of patients with DK is higher for those with T2DM because of more T2DM patients in China. Patients with T2DM who have a younger age, shorter duration of diabetes, and a lack of antidiabetic treatment will suffer from DK more often than older patients with longer T2DM duration and receiving antidiabetic treatment.© 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

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