C. Zhang, H. Huang, X. Zhu, W. Tang, L. Cao, C. Chen, et al. (2026). The hemoglobin-red blood cell distribution width ratio is a reliable predictor of recurrence of ketoacidosis in patients with type 2 diabetes. Frontiers in endocrinology, 17, 1772128. https://doi.org/10.3389/fendo.2026.1772128

PubMed 41953704

[Abstract]
BACKGROUND: Diabetic ketoacidosis is a common disease in the emergency department, characterized by severe metabolic disorders, which poses a significant threat to the life and health of patients with type 2 diabetes. Hemoglobin reflects the body's oxygen-carrying capacity and nutritional status, while the red cell distribution width indicates the heterogeneity in the size of red blood cells. The ratio of these two indicators can comprehensively reflect the systemic metabolic status and inflammatory state of patients with diabetic ketoacidosis.

OBJECTIVES: To study the association between the HRR and the recurrence of diabetic ketoacidosis.

METHODS: A retrospective study was conducted on patients with type 2 diabetic ketoacidosis at a local medical center. The HRR ratio at the time of the patients' first admission was collected. Statistical analysis was used to examine the relationship between the HRR ratio and the recurrence of DKA.

RESULTS: Logistic regression analysis revealed that HRR was associated with the recurrence of DKA. As the HRR value increased, the recurrence rate of DKA decreased. Additionally, ROC curve analysis indicated that the HRR ratio had good sensitivity and specificity in predicting the recurrence of type 2 diabetic ketoacidosis, with sensitivity values of 76.00% and 74.70%, respectively.

CONCLUSION: HRR is a reliable predictor for the recurrence of DKA.