Impact of ketoacidosis on long-term outcomes and quality of life in patients with type 1 diabetes mellitus: a retrospective study

Introduction. There is a rapid increase in the prevalence of type 1 diabetes every year around the world. Often the course of this disease is complicated by the development of diabetic ketoacidosis, which significantly worsens the patient’s long-term prognosis. Aim: To study a cohort of patients with type 1 diabetes mellitus depending on the presence or absence of diabetic ketoacidosis. To compare patient outcomes and quality of life depending on the occurrence of diabetic ketoacidosis in patients with type 1 diabetes mellitus. Material and Methods. The data of 502 patients hospitalized at the V.V.Vinogradov State Clinical Hospital for the decompensation of type 1 diabetes mellitus for the period from 2022 to 2023 were retrospectively analyzed. Clinical and anamnestic data, the results of instrumental (echocardiography and chest X-ray) examinations were evaluated, the presence or absence of diabetic ketoacidosis was established. In the long-term period, the life status of patients was established by telephone contact with the patient or his relative, and the quality of life was assessed based on the Short Form-36 questionnaire. Results. Median time of life quality and relapses observation after discharge was 18.5 [12.4; 24.0] months. Depending on the presence or absence of diabetic ketoacidosis, patients were divided into 2 groups: the group of patients with diagnosed diabetic ketoacidosis (DKA+) included 206 patients, the group of patients without signs of ketoacidosis (DKA-) – 296 patients. Clinically, patients in the DKA+ group were younger, males were more common, and disease duration was shorter compared to the DKA– group. Telephone contact was established with 84,5% (n = 174) of patients in the DKA+ group and 82.1% (n = 243) of patients in the DKA– group. The development of a fatal outcomes was noted in 1.9% (n = 4) of cases in the DKA+ group and 1.0% (n = 3) of cases in the DKA– group (p = 0.40). According to the results of the Short Form-36 questionnaire, there were no significant differences in the assessments of the physical and mental components of health between the groups (p > 0.05). Conclusion. Long-term outcomes in patients with type 1 diabetes mellitus and diabetic ketoacidosis were comparable to those in patients without a history of diabetic ketoacidosis. Previous diabetic ketoacidosis does not have a significant negative impact on the quality of life of patients in the long term in our trial.