ABSTRACT
Diabetic ketoacidosis (DKA) and hypoglycemia are the major life-threatening complications of diabetes. While the rates appear to be inching down, 20-30% of patients with type 1 diabetes (T1D) in most developed countries are diagnosed in DKA and the rates are much higher in developing countries. A small group of high-risk patients accounts for most of recurring DKA in long-standing T1D, but the incidence remains high, approximately 1 per 10 patient-years in countries where monitoring systems exist. Severe hypoglycemia, i.e., coma or seizure secondary to diabetes treatment remains high (up to 5/10 patient-years) and has recently increased among patients who aim for lower HbA1c targets without appropriate initial education and ongoing support. All three acute complications are theoretically preventable; unfortunately, they still account for an enormous morbidity, hospitalizations, and mortality among diabetic patients and contribute significantly to the high costs of diabetes care.
