Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study
Background: Diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar syndrome (HHS) are life-threatening complications of diabetes mellitus. However, limited data about DKA and HHS are available in patients with cancer. The current study aimed to determine characteristics and outcomes of patients...
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Elsevier
2025-01-01
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| Series: | Clinical Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1470211824054472 |
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| author | Rabia K. Shahid Qasem Haider Sunil Yadav Duc Le Shahid Ahmed |
| author_facet | Rabia K. Shahid Qasem Haider Sunil Yadav Duc Le Shahid Ahmed |
| author_sort | Rabia K. Shahid |
| collection | DOAJ |
| description | Background: Diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar syndrome (HHS) are life-threatening complications of diabetes mellitus. However, limited data about DKA and HHS are available in patients with cancer. The current study aimed to determine characteristics and outcomes of patients with cancer who were admitted with DKA/HHS in a mid-size Canadian city. Methods: Consecutive adult patients with an active cancer who were admitted with DKA or HHS from January 2008 to December 2020 in the city of Saskatoon, Saskatchewan, Canada were retrospectively evaluated. A univariate logistic regression analysis was performed to examine the correlation of various clinical variables with hospital mortality. Results: During the study period 6,555 patients with diabetes and cancer were admitted in one of the three tertiary care hospitals. Among them 33 (0.5 %) eligible patients with DKA or HHS with a median age of 60 years (range 36–94 years) were identified. In 36 % of patients, DKA or HHS was the presenting manifestation of newly diagnosed diabetes. Of all patients, 66 % developed DKA and 73 % had an advanced cancer. Overall, 52 % patients received a systemic cancer therapy prior to the admission, and 41 % received steroids. Ten (42 %) of 24 patients with an advanced cancer died, compared to none of the nine patients with an early-stage cancer (p = 0.032). No clinical factors significantly correlated with hospital mortality. Conclusions: Although DKA or HHS is uncommon in patients with diabetes and cancer, it is the manifestation of undiagnosed diabetes in about one-third of patients with cancer. It has been associated with high hospital mortality in patients with advanced cancer. |
| format | Article |
| id | doaj-art-a8496d28a5da4525b89d4603d57263fa |
| institution | Kabale University |
| issn | 1470-2118 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Medicine |
| spelling | doaj-art-a8496d28a5da4525b89d4603d57263fa2025-02-06T05:11:14ZengElsevierClinical Medicine1470-21182025-01-01251100262Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre studyRabia K. Shahid0Qasem Haider1Sunil Yadav2Duc Le3Shahid Ahmed4Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Corresponding author.College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Saskatchewan Cancer Agency, Saskatoon Cancer Center, Saskatoon, Saskatchewan, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Saskatchewan Cancer Agency, Saskatoon Cancer Center, Saskatoon, Saskatchewan, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Saskatchewan Cancer Agency, Saskatoon Cancer Center, Saskatoon, Saskatchewan, CanadaBackground: Diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar syndrome (HHS) are life-threatening complications of diabetes mellitus. However, limited data about DKA and HHS are available in patients with cancer. The current study aimed to determine characteristics and outcomes of patients with cancer who were admitted with DKA/HHS in a mid-size Canadian city. Methods: Consecutive adult patients with an active cancer who were admitted with DKA or HHS from January 2008 to December 2020 in the city of Saskatoon, Saskatchewan, Canada were retrospectively evaluated. A univariate logistic regression analysis was performed to examine the correlation of various clinical variables with hospital mortality. Results: During the study period 6,555 patients with diabetes and cancer were admitted in one of the three tertiary care hospitals. Among them 33 (0.5 %) eligible patients with DKA or HHS with a median age of 60 years (range 36–94 years) were identified. In 36 % of patients, DKA or HHS was the presenting manifestation of newly diagnosed diabetes. Of all patients, 66 % developed DKA and 73 % had an advanced cancer. Overall, 52 % patients received a systemic cancer therapy prior to the admission, and 41 % received steroids. Ten (42 %) of 24 patients with an advanced cancer died, compared to none of the nine patients with an early-stage cancer (p = 0.032). No clinical factors significantly correlated with hospital mortality. Conclusions: Although DKA or HHS is uncommon in patients with diabetes and cancer, it is the manifestation of undiagnosed diabetes in about one-third of patients with cancer. It has been associated with high hospital mortality in patients with advanced cancer.http://www.sciencedirect.com/science/article/pii/S1470211824054472CancerDiabetes mellitusDiabetes complicationsCancer treatmentDiabetic ketoacidosisHyperglycaemia hyperosmolar syndrome |
| spellingShingle | Rabia K. Shahid Qasem Haider Sunil Yadav Duc Le Shahid Ahmed Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study Clinical Medicine Cancer Diabetes mellitus Diabetes complications Cancer treatment Diabetic ketoacidosis Hyperglycaemia hyperosmolar syndrome |
| title | Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study |
| title_full | Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study |
| title_fullStr | Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study |
| title_full_unstemmed | Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study |
| title_short | Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer: A multicentre study |
| title_sort | diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome in patients with cancer a multicentre study |
| topic | Cancer Diabetes mellitus Diabetes complications Cancer treatment Diabetic ketoacidosis Hyperglycaemia hyperosmolar syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S1470211824054472 |
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