New diabetes research announced – DKA 15 November 2023 Speaking on World Diabetes Day (November 14), Diabetes Australia Group CEO Justine Cain said research is the key to changing the lives of the 1.5 million Australians living with diabetes. “Research is critical in our fight to drive change to prevent, treat and, ultimately, cure diabetes,” Ms Cain said. Professor Tony Russell, a leading endocrinologist and president of the Australian Diabetes Society, is a recipient of this year’s Diabetes Australia Research Program’s (DARP) Millenium Award for a multicentre trial into the treatment of diabetic ketoacidosis (DKA), a little-known but potentially fatal complication of diabetes. DKA is caused by the release of free fatty acids resulting from the body’s inability to produce insulin and utilise glucose. Free fatty acids form ketones in the blood which can make people feel very unwell – nausea, vomiting, abdominal pain and feeling generally tired. It’s a complication which is often mistaken for other conditions. For many people, it is how they are first diagnosed with diabetes. Melinda Newton of Clyde North knew her daughter Kirrily, now 12, was extremely tired and losing weight quickly but no one knew how sick Kirrily was. Kirrily was 9 when she was diagnosed with severe DKA and type 1 diabetes in 2021. “We had booked an appointment with the GP for the following day, but we got a call from the school nurse who said Kirrily was extremely fatigued and that her tummy was hurting,” Melinda said through tears, more than two years later. “I was at work so my husband went to pick her up. She was in a wheelchair to get to the car because she was so tired. Dave rang me and said, ‘She’s really scaring me’.” “He took her straight to the Emergency Department. She was admitted to intensive care with blood glucose levels of 44 and ketones of 6.” (A healthy range of BGLs is between 4 to 8mmol/L and ketones under 0.6mmol/L.) Kirrily was in severe DKA. Her parents were warned she could lapse into a coma at any time and that she could start fitting. Thankfully, Kirrily responded to treatment quickly and was transferred to a general ward after two nights in ICU. “I’d love to make people more aware of the symptoms of type 1 diabetes,” Melinda said. “I’d love to prevent DKA completely, but until then, we need to find out what’s the best treatment to help people like my daughter.” Professor Russell, working alongside a team of researchers, said more research is necessary for the management of DKA. “Because of the severity of dehydration in people experiencing DKA, fluid resuscitation is a cornerstone therapy,” Prof Russell said. “But the choice of fluid that results in the best clinical outcomes remains uncertain. “This research is an attempt to bridge the knowledge gap between plasmalyte, a balanced salt solution, and the routinely administered saline in patients with DKA. We are studying if administering plasmalyte shortens lengths of stays in ICUs and hospital generally.” Professor Russell said this research has the potential to provide definitive evidence to change the way clinicians treat DKA and reduce the length of hospital stays as a result. Ms Cain said that research into DKA is one of the 18 research initiatives being funded by Diabetes Australia across the country in 2024. The research announcement was made in Melbourne today as part of the Australian Centre for Accelerating Diabetes Innovations (ACADI) partnering summit. ACADI Director Professor Elif Ekinci said the centre is hosting a health tech innovation event where four research teams will compete for one $40,000 prize. Three of the projects are focusing on detecting and managing DKA. Research into diabetes emergencies such as DKA is one of ACADI’s research streams. “DKA is a leading cause of hospital admissions of people with type 1 diabetes, but people with type 2 are also at risk,” Prof Ekinci said. “Each year nearly 10,000 people are hospitalised with DKA, and an estimated 200 people die from it. Not enough research is being conducted into this condition, despite the sometimes fatal consequences,” she said. Members of the community can support Diabetes Australia research through a tax-deductible donation. Find out more about how to support us.