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Despite Advances, Gaps in DKA Recognition Persist Across Diabetes Populations
DKA remains a growing challenge in diabetes care, with new data highlighting missed diagnoses, rising admissions, and higher costs.
New data presented at the 86th Scientific Sessions of the American Diabetes Association are shedding light on the dangers of diabetic ketoacidosis (DKA) for people living with both type 1 and type 2 diabetes, highlighting sharp increases in DKA-related hospitalizations across all age groups nationwide.
Specifically, the research examined hospitalization, admission diagnosis and insurance claims data to better understand how DKA may be challenging to identify, its rising impact among young people, and a growing prevalence in adults with type 2 diabetes.
"These findings from Abbott show that diabetic ketoacidosis remains a growing challenge to identify, as DKA can develop quickly and mimic common illnesses," Kurt Midyett, MD, pediatric endocrinologist at Saint Luke's Endocrinology Specialists in Kansas City, MO, said in a statement. "When early symptoms are misattributed, delays in diagnosis are common and often result in lengthy and costly hospitalization. This data underscores the importance of addressing gaps in recognition to help detect rising ketones before DKA develops."
DKA Data at ADA Scientific Sessions
A study of > 100,000 people across the US found that DKA can be difficult to recognize when a person first arrives at the hospital, as early symptoms like nausea, fatigue, or stomach pain overlap with many common illnesses. A confirmed diagnosis of DKA depends on blood tests that measure blood sugar, blood pH and/or bicarbonate levels, and ketones, which may not be immediately available at admission, highlighting the need for approaches to recognize DKA earlier to provide timely care.
A second study of > 200,000 people showed that between 2017-2024, DKA hospitalization rates among people with type 1 diabetes increased approximately 24%, rising from 50 to 62 cases per 1000 individuals. Of note, the increase was more pronounced in children than adults, and most DKA events led to hospitalization for both children and adults, while severe hypoglycemia rates stayed low and stable, likely due to greater recognition of hypoglycemia and less awareness of DKA risk.
Another analysis of nearly 40,000 pediatric hospitalizations showed DKA now drives nearly 60% of all diabetes-related hospitalizations among youth with type 1 or type 2 diabetes. Most US hospitalizations among children with diabetes are related to DKA, with the majority requiring inpatient care lasting up to 1 week and costing as much as $38,000 per stay.
Findings from a separate study with data from millions of people indicate DKA is likely underreported in adults with type 2 diabetes, and when diagnosed after admission as a secondary condition, is associated with longer hospital stays, higher costs, and increased rates of death.
"These new data make clear that preventing diabetic ketoacidosis starts with recognizing risk earlier," said Mahmood Kazemi, MD, chief medical officer for Abbott's diabetes care business. "DKA remains one of the most preventable emergencies in diabetes care, yet too many people still miss early warning signs when ketones levels begin to rise. These findings underscore the need for better ways to recognize risk sooner and help reduce avoidable hospitalizations."
Advancing Ketone Monitoring Technologies
Despite the essential role continuous glucose monitors (CGMs) play in diabetes management, they do not currently measure ketones, and DKA can still develop even when glucose levels appear stable. Because rising ketones can progress to DKA within hours, earlier visibility has the potential to prompt action sooner and reduce risk.
As an alternative to existing ketone monitoring options, Abbott’s dual glucose-ketone sensing technology combines continuous glucose and ketone monitoring in a single sensor designed to support both daily diabetes management and help to detect rising ketone levels for people living with diabetes.
In May 2026, Abbott announced CE Mark for its Libre Duo and Libre Duo 10 Day systems. The company has also filed a regulatory submission with the US Food and Drug Administration.
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