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==Epidemiology== Diabetic ketoacidosis occurs in 4.6–8.0 per 1000 people with diabetes annually.<ref name=ADA2006/> Rates among those with type 1 diabetes are higher with about 4% in the United Kingdom developing DKA a year while in [[Malaysia]] the condition affects about 25% a year.<ref name=BMJ2015/><ref name=Mal2013/> In the United States, 135,000 hospital admissions occur annually as a result of DKA, at an estimated cost of $2.4 billion or a quarter to half the total cost of caring for people with type 1 diabetes. There has been a documented increasing trend in hospital admissions.<ref name=ADA2009/> The risk is increased in those with an ongoing risk factor, such as an eating disorder, and those who cannot afford insulin.<ref name=ADA2009/> About 30% of children with type 1 diabetes receive their diagnosis after an episode of DKA.<ref>{{cite journal | vauthors = Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, Deeb L, Grey M, Anderson B, Holzmeister LA, Clark N | display-authors = 6 | title = Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association | journal = Diabetes Care | volume = 28 | issue = 1 | pages = 186–212 | date = January 2005 | pmid = 15616254 | doi = 10.2337/diacare.28.1.186 | url = http://care.diabetesjournals.org/content/28/1/186.full | url-status = live | doi-access = | s2cid = 6002670 | archive-url = https://web.archive.org/web/20160419083507/http://care.diabetesjournals.org/content/28/1/186.full | archive-date = 2016-04-19 }}</ref> Lower socio‐economic status and higher area‐level deprivation are associated with an increased risk of diabetic ketoacidosis in people with diabetes mellitus type 1.<ref>{{cite journal | vauthors = Lindner LM, Rathmann W, Rosenbauer J | title = Inequalities in glycaemic control, hypoglycaemia and diabetic ketoacidosis according to socio-economic status and area-level deprivation in Type 1 diabetes mellitus: a systematic review | journal = Diabetic Medicine | volume = 35 | issue = 1 | pages = 12–32 | date = January 2018 | pmid = 28945942 | doi = 10.1111/dme.13519 | s2cid = 24297858 }}</ref> Previously considered universally fatal, the risk of death with adequate and timely treatment is between <1% and 5%.<ref name=BMJ2015/><ref name=JBDS/> Up to 1% of children with DKA develop a complication known as [[cerebral edema]].<ref name=Bia2015>{{cite journal | vauthors = Bialo SR, Agrawal S, Boney CM, Quintos JB | title = Rare complications of pediatric diabetic ketoacidosis | journal = World Journal of Diabetes | volume = 6 | issue = 1 | pages = 167–174 | date = February 2015 | pmid = 25685287 | pmc = 4317308 | doi = 10.4239/wjd.v6.i1.167 | doi-access = free }}</ref> Rates of cerebral edema in US children with DKA have risen from 0.4% in 2002 to 0.7% in 2012.<ref>{{cite journal | vauthors = Patel A, Singh D, Bhatt P, Thakkar B, Akingbola OA, Srivastav SK | title = Incidence, Trends, and Outcomes of Cerebral Edema Among Children With Diabetic Ketoacidosis in the United States | journal = Clinical Pediatrics | volume = 55 | issue = 10 | pages = 943–951 | date = September 2016 | pmid = 26603587 | doi = 10.1177/0009922815617975 | s2cid = 25624176 }}</ref> Between 2 and 5 out of 10 children who develop brain swelling will die as a result.<ref name=Brown2004>{{cite journal | vauthors = Brown TB | title = Cerebral oedema in childhood diabetic ketoacidosis: is treatment a factor? | journal = Emergency Medicine Journal | volume = 21 | issue = 2 | pages = 141–144 | date = March 2004 | pmid = 14988335 | pmc = 1726262 | doi = 10.1136/emj.2002.001578 }}</ref>
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