Prevention of diabetic ketoacidosis in Newfoundland and larador: hospitalization rates pre and post a multiphase provincial knowledge translation program

Darmonkow, Georgia M. (2019) Prevention of diabetic ketoacidosis in Newfoundland and larador: hospitalization rates pre and post a multiphase provincial knowledge translation program. Masters thesis, Memorial University of Newfoundland.

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Abstract

Background & Objectives: The province of Newfoundland and Labrador (NL) has one of the highest rates of type 1 diabetes mellitus globally. Diabetic ketoacidosis (DKA) is one of the major complications of this disease. The Newfoundland and Labrador Diabetic Ketoacidosis Project (NLdkaP) is a multiphase project aimed at lowering the rates of DKA in the province. In order to assess the effectiveness of this project, we studied hospitalization rates for type 1 diabetes over a six–year period. Design, Setting & Measurements: This is a retrospective study carried out in NL using hospital administrative data covering the period January 1, 2009 – December 31, 2014 for patients aged ≤24 years. Data extracted for each patient included demographic factors (e.g., sex and age), location of treatment, length of stay, and whether the patient has had recurrent DKA. Results: There were 412 patients admitted for DKA over the study period. DKA hospitalizations in the province decreased for the two years during the NLdkaP (2011 and 2012; n = 107). In the two years post project (2013 and 2014), DKA hospitalizations increased (n = 148) but rates did not increase to the initial rates measured before the project was implemented in (2009 and 2010; n = 157). Conclusions: The NLdkaP was associated with a decrease in DKA hospitalization rates. This knowledge translation project could be adopted by other regions to reduce the rates of DKA hospitalizations. Ongoing efforts are needed to sustain this preventative effect.

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