Improving care for people admitted with diabetes-related emergencies

Developing a patient-physician co-created national diabetes-related emergencies management monitoring model

Status

Recruiting

Phases

Unknown

Study type

Observational

Source

ISRCTN

Registry ID

ISRCTN17096714

Enrollment

Registered

2026-07-14

Start date

2025-06-23

Completion date

Unknown

Last updated

2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes mellitus Nutritional, Metabolic, Endocrine

Interventions

The DEKODE study is designed to improve the care of people admitted to hospital with diabetes-related emergencies. It consists of four work packages, each focusing on a specific aspect of DKA care. Be

Eligibility

Sex/Gender

All

Age

16 Years to 99 Years

Inclusion criteria

Inclusion criteria: Work Package 1: Patients admitted with DKA from 1 January 2001 to 31 December 2023. Work Package 2: 1. Patients: 1.1. Those admitted to the hospital with DKA 1.2. Have the capacity to provide consent 1.3. Aged 16-99 years 2. Carers: 2.1. Those who are identified by patients as recruited above 2.2. Have the capacity to provide consent 2.3. Aged 16-99 years 3. Healthcare workers: 3.1. Those involved in treating DKA for patients recruited above 3.2. Have the capacity to provide consent Work Package 3: Healthcare professionals involved in providing DKA care in hospitals participating in DEKODE

Exclusion criteria

Exclusion criteria: Work Package 1: Individuals with non-diabetic ketoacidosis or other metabolic disorders that could confound the study results Work Package 2: 1. Patients without DKA 2. Providers not directly involved in DKA care 3. Unable to provide consent Work Package 3: Individuals who do not have sufficient interaction with the DKA care process

Design outcomes

Primary

Measure	Time frame
Work Package 1 – Assessing inequities in DKA care and outcomes in the UK Objective 1.1: Crude incidence rate of DKA (number of new cases per 100,000 person-years), measured using CPRD Aurum/GOLD linked to HES (ICD-10 codes E10.0–E14.1), calculated annually from 01/01/2001 to 31/12/2023, stratified by age, sex, ethnicity, deprivation, mental health status, and region. Objective 1.2: Length of hospitalisation, measured using HES data, at the index DKA admission. Work Package 2 – Lived experiences of people treated for and treating DKA Patient-reported experience of DKA care, measured using the NHS Inpatient Questionnaire for people with diabetes (Microsoft Forms) and the EQ-5D-Y questionnaire, at baseline (inpatient admission), 3 months and 6 months post-discharge. Work Package 3 – DEKODE model implementation and effectiveness Variation in DEKODE implementation across NHS Trusts, measured using thematic analysis of semi-structured interviews with stakeholders (applying NASSS and CFIR frameworks), at the time of interview across six consecutive quarterly DEKODE data cycles. Work Package 4 – Investigating recurrent DKA Frequency and predictors of recurrent DKA (defined as =2 DKA episodes), measured using pseudonymised DEKODE national audit data and NHS hospital records, across the full study period. Work Package 5 – Health economics evaluation of the DEKODE model Cost of managing a single DKA episode, measured using NHS procurement data and DEKODE audit data (direct and indirect costs), at baseline and at 12, 18, and 24 months after DEKODE adoption in participating institutions.	—

Measure

Time frame

Work Package 1 – Assessing inequities in DKA care and outcomes in the UK Objective 1.1: Crude incidence rate of DKA (number of new cases per 100,000 person-years), measured using CPRD Aurum/GOLD linked to HES (ICD-10 codes E10.0–E14.1), calculated annually from 01/01/2001 to 31/12/2023, stratified by age, sex, ethnicity, deprivation, mental health status, and region. Objective 1.2: Length of hospitalisation, measured using HES data, at the index DKA admission. Work Package 2 – Lived experiences of people treated for and treating DKA Patient-reported experience of DKA care, measured using the NHS Inpatient Questionnaire for people with diabetes (Microsoft Forms) and the EQ-5D-Y questionnaire, at baseline (inpatient admission), 3 months and 6 months post-discharge. Work Package 3 – DEKODE model implementation and effectiveness Variation in DEKODE implementation across NHS Trusts, measured using thematic analysis of semi-structured interviews with stakeholders (applying NASSS and CFIR frameworks), at the time of interview across six consecutive quarterly DEKODE data cycles. Work Package 4 – Investigating recurrent DKA Frequency and predictors of recurrent DKA (defined as =2 DKA episodes), measured using pseudonymised DEKODE national audit data and NHS hospital records, across the full study period. Work Package 5 – Health economics evaluation of the DEKODE model Cost of managing a single DKA episode, measured using NHS procurement data and DEKODE audit data (direct and indirect costs), at baseline and at 12, 18, and 24 months after DEKODE adoption in participating institutions.

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Secondary

Measure	Time frame
There are no secondary outcomes	—

Countries

England, United Kingdom

Contacts

Public ContactKalyaani Persad

k.persad@bham.ac.uk+44 (0)7584811046

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Sep 11, 2026