在英格兰,2 型糖尿病成人患者因 DKA 而入院的发病率在 1998 至 2013 年间每年增长 4.24%;1 型糖尿病成人患者因 DKA 而入院的发病率从 1998 至 2007 年逐年增加,至 2013 年前保持静止。[7]Zhong VW, Juhaeri J, Mayer-Davis EJ. Trends in hospital admission for diabetic ketoacidosis in adults with type 1 and type 2 diabetes in England, 1998-2013: A retrospective cohort study. Diabetes Care. 2018 Jan 31.[Epub ahead of print].http://www.ncbi.nlm.nih.gov/pubmed/29386248?tool=bestpractice.com
在丹麦,一般人群中从 1996 至 2002 年间 DKA 的年发病率估计为 12.6/100,000,且男性发病率高于女性 (14.4 vs 11.4/100,000,p<0.0001)。[8]Henriksen OM, Roder ME, Prahl JB, et al. Diabetic ketoacidosis in Denmark. Incidence and mortality estimated from public health registries. Diabetes Res Clin Pract. 2007;76:51-56.http://www.ncbi.nlm.nih.gov/pubmed/16959363?tool=bestpractice.com 12% 的患者(通常是年龄超过 50 岁的患者)被诊断为 2 型糖尿病。总体死亡率为 4%。[8]Henriksen OM, Roder ME, Prahl JB, et al. Diabetic ketoacidosis in Denmark. Incidence and mortality estimated from public health registries. Diabetes Res Clin Pract. 2007;76:51-56.http://www.ncbi.nlm.nih.gov/pubmed/16959363?tool=bestpractice.com 在瑞典,1999 至 2000 年间,16% 的新发糖尿病患儿出现 DKA;0.68% 的病例出现脑水肿。[9]Hanas R, Lindgren F, Lindblad B, et al. Diabetic ketoacidosis and cerebral oedema in Sweden - a 2-year paediatric population study. Diabetic Med. 2007;24:1080-1085.http://www.ncbi.nlm.nih.gov/pubmed/17672863?tool=bestpractice.com 在芬兰,1992 至 2001 年间 1 型糖尿病患儿出现 DKA 的水平相似 (15.2%);诊断时年龄小于 2 岁的患儿患 DKA 的风险最高。[10]Hekkala A, Knip M, Veijola R, et al. Ketoacidosis at diagnosis of type 1 diabetes in children in northern Finland: temporal changes over 20 years. Diabetes Care. 2007;30:861-866.http://care.diabetesjournals.org/content/30/4/861.fullhttp://www.ncbi.nlm.nih.gov/pubmed/17392547?tool=bestpractice.com 在巴西,有 32.8% 的患者在诊断 1 型糖尿病时即出现 DKA。[11]Rodacki M, Pereira JR, Nabuco de Oliveira AM. Ethnicity and young age influence the frequency of diabetic ketoacidosis at the onset of type 1 diabetes. Diabetes Res Clin Pract. 2007;78:259-262.http://www.ncbi.nlm.nih.gov/pubmed/17478002?tool=bestpractice.com诊断糖尿病时出现 DKA 更常见于年龄小于 10 岁的儿童以及非白人(相对于白人)。[11]Rodacki M, Pereira JR, Nabuco de Oliveira AM. Ethnicity and young age influence the frequency of diabetic ketoacidosis at the onset of type 1 diabetes. Diabetes Res Clin Pract. 2007;78:259-262.http://www.ncbi.nlm.nih.gov/pubmed/17478002?tool=bestpractice.com
在美国,2000 至 2009 年间 DKA 的入院率整体上是下降的,从 21.9 人下降至 19.5 人/1000 糖尿病患者,但从 2009 至 2014 年间又增长至 30.2 人/1000 糖尿病患者。[12]Benoit SR, Zhang Y, Geiss LS, et al. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality - United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):362-365.https://www.cdc.gov/mmwr/volumes/67/wr/mm6712a3.htm?s_cid=mm6712a3_whttp://www.ncbi.nlm.nih.gov/pubmed/29596400?tool=bestpractice.com 2014 年,DKA 的入院率在年龄 <45 岁的患者中最高(44.3 人/1000 糖尿病患者),并且随年龄增长而降低(45-64 岁患者为 5.2 人/1000 糖尿病患者;65-74 岁患者为 1.6 人/1000糖尿病患者;而在 ≥75 岁患者中为 1.4 人/1000 糖尿病患者)。[12]Benoit SR, Zhang Y, Geiss LS, et al. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality - United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):362-365.https://www.cdc.gov/mmwr/volumes/67/wr/mm6712a3.htm?s_cid=mm6712a3_whttp://www.ncbi.nlm.nih.gov/pubmed/29596400?tool=bestpractice.com 从 2000 至 2014 年间,DKA 患者的住院死亡率从 1.1% 持续下降至 0.4%。[12]Benoit SR, Zhang Y, Geiss LS, et al. Trends in diabetic ketoacidosis hospitalizations and in-hospital mortality - United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):362-365.https://www.cdc.gov/mmwr/volumes/67/wr/mm6712a3.htm?s_cid=mm6712a3_whttp://www.ncbi.nlm.nih.gov/pubmed/29596400?tool=bestpractice.com 2014 年,美国年龄在 18 岁或以上的人中有约 207,000 次突发和急诊就诊属于高血糖危象(例如,DKA、高血糖高渗性状态)。[13]Centers for Disease Control and Prevention. National diabetes statistics report, 2017. February 2018 [internet publication].https://www.cdc.gov/diabetes/data/statistics/statistics-report.html