A Retrospective Study of The Prevalence of Diabetic Ketoacidosis in Saudi Adolescents and Adults with Type 1 Diabetes | [Journal of Pioneering Medical Sciences • 2024]

Author(s):

1. Mohammed Zaid Aljulifi: Department of Family and Community Medicine, College of Medicine, Majmaah University, Majmaah 11952, Saudi Arabia

2. Moeber Mahzari: Department of Medicine, Division of Endocrinology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

3. Hadania Adil Fatani: King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Family Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia

4. Husam I Ardah: King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

Abstract:

Objectives: To assess the frequency and predictors of diabetic ketoacidosis (DKA) in adolescents and adults with type 1 diabetes (T1DM). Methodology: This retrospective analysis involved patients over the age of 12 who were monitored at the endocrine clinic of King Abdulaziz Medical City in Riyadh from July 2019 to July 2020. A comparison was made between patients with diabetic ketoacidosis (DKA) and those without, utilizing the chi-squared test or Fisher's exact test for categorical variables and the t-test or Kruskal-Wallis test for continuous variables. Independent risk factors were determined through multivariate logistic regression analysis. Results: Among the 262 patients diagnosed with Type 1 Diabetes Mellitus (T1DM), 56.1% were female, with an average age of 22.6 years (± 8.07). Approximately 58% of these patients reported a history of diabetic ketoacidosis (DKA), and 46.9% experienced DKA at the time of diagnosis. The average glycated hemoglobin level recorded was 9.0% (± 1.80). Missing appointments at the endocrine clinic was linked to increased hospital admissions due to DKA. Of those with a DKA history, 81.6% experienced it once annually, while 18.4% had multiple hospitalizations. The average age of patients during admission was 18.1 years (± 7.33), with an average hospital stay of 2.9 days (± 1.53). Although most DKA episodes were classified as mild to moderate, 19.7% were severe. The primary reason for DKA was identified as noncompliance with insulin therapy, accounting for 52% of cases. Conclusions: DKA is frequently observed in individuals with T1DM in Saudi Arabia, largely attributed to nonadherence to insulin therapy. Around one-third of these patients encounter recurrent or severe episodes of DKA. It is advisable to engage in regular conversations regarding insulin adherence and the management of illness-related complications.

Page(s): 4-12

DOI: 10.5001/omj.2021.124

Published: Journal: Journal of Pioneering Medical Sciences, Volume: 13, Issue: 6, Year: 2024

Keywords:

Type 1 diabetes , Risk factors , Prevalence , Prevalence , Diabetic ketoacidosis , Saudi Arabia

References:

[1] . .. , : 12404-0407.

[2] Al-Agha A. .2011 ."Metabolic control in children and adolescents with insulin-dependent diabetes mellitus at King Abdul-Aziz University Hospital.". Journal of Clinical Research in Pediatric Endocrinology 3.4, 10 : 202-207.

[3] Umpierrez G. E.,Disorders Related .2020 ."Hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state." Diabetes Complications, Comorbidities. , : 21-614.

[4] Dhatariya ,Ketan K. .2020 .. "Diabetic ketoacidosis." Nature Reviews Disease Primers 6.1, : 40.

[5] Maletkovic Andrew,Drexler Andrew .2013 ."Diabetic ketoacidosis and hyperglycemic hyperosmolar state. " Endocrinology and Metabolism Clinics 42.4, 07 : 677-695.

[6] Duca L. M. .2017 ."Diabetic ketoacidosis at diagnosis of type 1 diabetes predicts poor longterm glycemic control. " Diabetes Care, 40 : 0558-1255.

[7] Al-Hayek .2014 ."Assessment of healthrelated quality of life among adolescents with type 1 diabetes mellitus in Saudi Arabia.". Saudi Med J 35.7, : 712-7.

[8] Ahmed ,Ahmed M. .2016 ."Reduced frequency and severity of ketoacidosis at diagnosis of childhood type 1 diabetes in Northwest Saudi Arabia.". -0077, : 259-264.

[9] A. .2019 ."Incidence of diabetic ketoacidosis in newly diagnosed type 1 diabetes children in western Saudi Arabia: 11-year experience. " Journal of Pediatric Endocrinology and Metabolism 32.8, : 857-862.

[10] Habib Hamid,Saeed Hamid .2005 ."Frequency and clinical characteristics of ketoacidosis at onset of childhood type 1 diabetes mellitus in Northwest Saudi Arabia.". Saudi medical journal 26.1, : .

[11] Batwa ,Mawaddah .2022 ."Diabetic ketoacidosis at the onset of type 1 diabetes mellitus among children and adolescents in Jeddah, Saudi Arabia: A study from the emergency department. " Cureus 14.4, 10 : .

[12] Albishi L. A. .2017 .". Journal of Diabetes Mellitus 7.2, : 41-54.

[13] Abduljabbar .2010 ."Incidence trends of childhood type 1 diabetes in eastern Saudi Arabia.". Saudi medical journal 31.4, : 413-418.

[14] Kulaylat Hassib,Narchi Hassib,Kulaylat Hassib,Narchi Hassib .2006 ."Clinical picture of childhood type 1 diabetes mellitus in the Eastern Province of Saudi Arabia.". Pediatric Diabetes 2.1, 02242 : 1442-200X.

[15] Al-Ghamdi A. H.,Fureeh A. A. .2018 ."Prevalence and clinical presentation at the onset of type 1 diabetes mellitus among children and adolescents in Al-Baha region. Saudi Arabia." Journal of Pediatric Endocrinology and Metabolism 31.3, : .

[16] M. ,Habib and H. .2004 ."Clinical presentation of childhood type 1 diabetes mellitus in the Al-Madina region of Saudi Arabia.". Pediatric Diabetes 5.2, 00046(2004) : 1399-543X.

[17] Sayed M. H. .2017 ."Risk factors and predictors of uncontrolled hyperglycemia and diabetic ketoacidosis in children and adolescents with type 1 diabetes mellitus in Jeddah, western Saudi Arabia.". Journal of Diabetes 9.2, : .

Citations

Downloads

Views