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| Author | Diagnosis of DKA | Determination of thyroxine | Inclusion criteria | Exclusion criteria | Therapeutic method | Treatmenttime | Subgroup |
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| Yan Zhao | NA | https://fanyi.baidu.com/, https://fanyi.baidu.com/, https://fanyi.baidu.com/-zh/en/javascript:void(0), chemiluminescence | There was no thyroid disease in the past, and no drugs affecting thyroid function were taken recently | NA | Untreated | | Mild: pH < 7.3 or HCO3− < 15 mmol·L
Moderate: pH < 7.2 or HCO3− < 10 mmol·L
Severe: pH < 7.1 or HCO3− < 5 mmol·L |
| Shixiong Zhang | | Microparticle automatic chemiluminescence immunoassay analyzer (Beckman, USA) | There was no abnormal ECG and liver function. | Patients with hypoproteinemia, thyroid disease, heart failure, fever, kidney disease, and acute viral hepatitis, as well as glucocorticoid, androgen, and estrogen were excluded | On the basis of routine diabetes treatment, the observation group was given routine treatment such as rehydration, removing inducement, maintaining acid-base and water-electrolyte balance, insulin, and other conventional treatment measures to correct ketoacidosis. | 3 w | |
| Yunzhi Wang | | Beckman microparticle automatic chemiluminescence immunoassay analyzer and corresponding kits provided by the company | The liver function and ECG were normal | Thyroid disease, acute viral hepatitis, hypoproteinemia, heart failure, kidney disease, infection, fever, pregnant women, and the use of estrogen, androgen, and glucocorticoid. | According to the treatment principle of ketoacidosis, the treatment includes removing the inducement, replenishing fluid, applying insulin, and maintaining the acid-base balance of water and electrolyte | 3 w | |
| Yiping Wang | | Beckman access 2 chemiluminescence immunoassay analyzer was used | There was no history of other acute and chronic diseases | Severe heart, liver, kidney, and connective tissue diseases
Previous history of thyroid disease, taking thyroid function drugs
Pregnant and lactating women | Treatment method unknown | unknown | Mild pH < 7.3 or HCO3− < 15 mmol/L
Moderate pH < 7.2 or HCO3− < 10 mmol/L
Severe pH < 7.1 or HCO3− < 5 mmol/L |
| Lan Wang | | | Primary thyroid diseases, no history of antithyroid drugs and thyroid surgery were excluded | | Treatment method unknown | unknown | |
| Yu Qiao | The symptoms of diabetes were aggravated, nausea, vomiting, dizziness, and other discomfort clinical manifestations
Dry skin, sunken orbit, rapid pulse, and other signs
Blood glucose >16 mmol/L, urine ketone body and urine sugar positive, blood gas analysis, anion gap increased, HCO3−decreased, and binding rate decreased (note: due to individual differences, some patients who have no obvious clinical symptoms or signs but meet the laboratory examination are also diagnosed with diabetic ketoacidosis) | | | Pregnant or lactating women
Patients with thyroid disease history and taking drugs affecting thyroid function
Patients with severe liver, heart, kidney, and connective tissue diseases; 40 patients with thyroid function analysis
Patients with other crisis critical patients at admission
Patients without the thyroid function test and blood gas analysis on admission. | Untreated | | |
| Lianshan Piao | | The immunoassay kit was provided by the Institute of Isotope, Chinese Academy of Atomic Energy | No pituitary, adrenal, and thyroid diseases were found, and no serious complications of chronic diabetes were found | | After the treatment of high-dose rehydration and low-dose insulin continuous intravenous therapy | Urinary ketone body turned negative and carbonate ion returned to normal | |
| Li Luo | | Siemens Centaur XP chemiluminescence immunoassay system | | Other diseases that may affect thyroid function were excluded, and drugs affecting thyroid function were excluded | Untreated | | |
| Shengbin Liu | | | | Combined with serious heart, brain, liver, kidney, and other organ damage, thyroid disease, central nervous system systemic diseases, pregnant women having dopamine, glucocorticoid, androgen, and estrogen within 3 months may affect their own hormone levels, thus interfering with the drug use history of this study and having suffered from endocrine system diseases such as primary aldosteronism, and growth retardation | Untreated | | Mild (pH ≥ 7.3)
Moderate (7.3>pH ≥ 7.2)
Severe (pH < 7.2) |
| Bin Liu | | | There was no history of thyroid disease, endocrine, glucocorticoid, sedative, furosemide, dopamine, and other drugs in the past, except lactation and pregnancy women. | | Untreated | | |
| Shaohui Huang | | Microparticle automatic chemiluminescence analyzer (Beckman company, USA) | All the patients met the diagnostic criteria of diabetes established by the WHO | Abnormal ECG, abnormal liver function, the history of glucocorticoid, androgen, thyroid disease, infection, heart failure, and mental disease | Active treatment of primary disease, adequate fluid supplement, insulin, correction of water-electrolyte balance disorder, acid-base balance, and symptomatic treatment measures were adopted. | 3 w | |
| Rui Feng | Blood glucose was higher than 13.9 mmol/L, pH was less than 7.35, urine ketone was positive, anion gap was more than 16 mmol/L, and blood bicarbonate (HCO3−) was less than 18 mmol/L | Enzyme linked immunosorbent assay | | Ketoacidosis caused by acute cardiovascular and cerebrovascular diseases, gastrointestinal bleeding, major surgery, and pregnancy were excluded | All patients were treated with antibiotics to prevent infection, supplement electrolytes, and maintain body fluid balance. Patients with other basic diseases or complications were treated according to their condition. On this basis, the patients were treated with low-dose insulin intravenous drip, and the dose was 4–6 u/h | 24 h | |
| Wen Fan | | Abbott i2000 chemiluminescence immunoassay system and its kit | Age ≥65 years.
According to the diagnostic criteria issued by the American Diabetes Association in 2010.
Informed consent in this study. | There are hypothyroidism diseases, such as graves’ disease and Hashimoto’s thyroiditis.
Those who have recently taken drugs that affect thyroid function, such as estrogen, androgen, and glucocorticoid.
Combined with acute viral hepatitis, hypoproteinemia, heart failure, kidney disease, infection, and so on. | Treatment method unknown | Unknown | |
| Fuwan Ding | | Radioimmunoassay | | Patients with the history of thyroid disease, severe heart, liver, kidney disease, and connective tissue were excluded. | Resuscitation measures such as fluid rehydration, use of insulin to lower blood sugar, correction of water-electrolyte and acid-base imbalance, treatment of complications and comorbidities, and removal of ketosis inducements have stabilized the condition within 1–3 days. All patients did not use thyroxine preparations | 2 w | |
| Qing Chen | | Chemiluminescence | | The history of thyroid diseases, patients taking drugs that affect thyroid function, severe heart, liver, kidney, and connective tissue diseases, breast-feeding, and pregnant women | untreated | | |
| Daoxiong Chen | Diabetes (according to the WHO’s diagnostic criteria for diabetes)
Positive blood ketones
Blood gas analysis showed metabolic acidosis | | None of the observed patients had clinical manifestations of hyperthyroidism or hypothyroidism and no history of thyroid disease | | Treatment method unknown | 2 w | |
| Rashidi. H | | | Without any history of thyroid problems, systemic diseases, and using drugs which interfere with thyroid function were enrolled into the study. | | Treatment method unknown | 2w | |
| Naeije. R. G | | | | | Untreated | 5 days | |
| Schienger. J. L | | | Clinically euthyroid | | Untreated | | |
| Alexander 1983 | | Double antibody RIA commercial method (Abbott Laboratories, North Chicago, IL). | | We limited the scope of our study to the effects of diabetes mellitus per se by excluding patients with other systemic illnesses | Insulin | 5 days | |
| Miboluk. AA | | Two different methods: radio immune assay (RIA) and immune-radiometric assay (IRMA) | Blood sugar> 300 mg/dl, HCO3− ≤ 15 mol/l PH ≤ 7.3, urine ketone positive | Severe nutritional deficiency, neurologic side effects, and brain edema/coma in ketoacidotic status | Insulin | 5 days | |
| Lin. C. H | Serum glucose level 300 mg/dl (16.7 mmol/L), a serum pH < 7.25 or serum bicarbonate < 15 mmol/L, and the presence of ketones in the urine. | T3 was measured by radioimmunoassay (ICN, New York, USA; reference range, 100 to 190 ng/dl), T4 by radioimmunoassay (Daiichi, Tokyo, Japan; reference range, 4.4–12.5 μg/dl), TSH by radioimmunometric assay (Daiichi, Tokyo, Japan; reference range, 0.5–5.15 IU/ml), and free T4 by radioimmunoassay, using the 125I-labeled T4 analogue method (DPC, Los Angeles, USA; reference range, 0.8–2.0 ng/dl). | Clinically euthyroid | | | 3 days | |
| Jiao W | Blood glucose level >13.9 mmol/L, blood pH < 7.35, ketonuria positivity, anion gap (AG) > 16 mmol/L, and HCO3− level < 18 mmol/L | Enzyme linked immunosorbent assay (ELISA) | | Patients with DKA induced by acute cardiovascular and cerebrovascular diseases, gastrointestinal haemorrhage, major surgery, or pregnancy were excluded | Supportive treatment such as fluid infusion, acid-base imbalance correction, and electrolyte disturbance corintravenous insulin administered by an insulin pump at a rate of 4–6 U/h. | 24 h | |
| Hu Y Y | Blood glucose (BG) > 11 mmol/L, venous pH < 7.3, or bicarbonate < 15 mmol/L | Automated chemiluminescent immunoassay system (Advia Centaur, Siemens, Munich, Germany). | | Excluded patients with other endocrinological disorders, systemic illness, pituitary and thyroid disease, and a history of diabetes mellitus. Patients who had previously received any medication apart from insulin were also excluded | After resolution of DKA, patients received multiple daily insulin injections, aspart (Novo Nordisk, Bagsvaerd, Denmark) immediately before each meal and glargine (Sanofi-Aventis, Paris, France) once daily at bedtime. The total daily insulin dose ranged from 0.6 to 1.5 IU/kg. | 7 days | |
| D. Glinoer, R | | Serum FT 4 was measured using the kinetic FT4-I125 radioimmunoassay test system (kindly provided by Dr. G. Odstrchel, Corning Glass Works, Corning, NY, USA) | | | Low-dose insulin. Fluids and electrolytes | 5 days | |
| F. Chiarelli | pH < 7.2, HCO3− < 15 mmol/1, ketonuria: 4+). | | Without familiar or personal history for endocrinological diseases. No drugs (except insulin for the diabetics) were administered to the children. All the subjects examined were clinically euthyroid, and their weight did not exceed ideal body by more than 20%. | | Untreated | | |
| Alexander, 1982 | | Double antibody RIA | | | Untreated | | |
| Xin Y | Hyperglycaemia above 14 mmol/L and pH < 7.3 or bicarbonate < 15 mmol/L in the presence of ketonuria | | | | Untreated | | |
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