TK. Derse, DM. Kidie, AS. Asgai, T. Lidetu and MT. Abebe (2025). Diabetic ketoacidosis treatment outcomes and associated factors among adult diabetic patients in Ethiopia: A systematic review and meta-analysis. Metabolism open, 26, 100360. https://doi.org/10.1016/j.metop.2025.100360

PubMed 40231199

[Abstract]
BACKGROUND: Diabetic ketoacidosis is a severe complication of diabetes that can threaten life and has a considerable effect on healthcare systems, especially in developing nations such as Ethiopia. Although it is clinically significant, comprehensive data on the factors that lead to unsatisfactory treatment outcomes in diabetic ketoacidosis patients in Ethiopia are lacking. This review aims to investigate and evaluate unsatisfactory treatment outcomes and multiple contributing factors related to diabetic ketoacidosis among patients with diabetes in Ethiopia. This review seeks to identify these factors to provide insights that can guide improvements in the management and treatment of diabetic patients.

METHODS: Articles documenting unfavorable treatment outcomes and related aspects of diabetic ketoacidosis among Ethiopian diabetes patients were meticulously sought from various databases, including PubMed/MEDLINE, the Cochrane Library, Science Direct, HINARI, Google Scholar, and gray literature. After the data were extracted, they were imported into Stata software version 17 for analysis. The Cochrane Q test and I2 statistic were used to evaluate heterogeneity.

RESULTS: A total of 580 duplicates were eliminated from the initial set of 1578 papers obtained from PubMed (3), Google Scholar (1,550), HINARI (11), Science Direct (13), and the Cochrane Library (1). The pooled prevalence of poor treatment outcomes for diabetic ketoacidosis was 8 %. Key risk factors for poor treatment outcomes included a Glasgow Coma Scale (GCS) score of less than 15 (POR = 3.16; 95 % CI: 1.52-4.80), sepsis (POR = 2.92; 95 % CI: 1.12-4.72), and comorbidities (POR = 3.66; 95 % CI: 1.64-5.68).

CONCLUSION: The pooled prevalence of poor treatment outcomes of diabetic ketoacidosis in Ethiopia was high. A GCS score of less than 15, sepsis, and comorbidities were identified as significant risk factors for poor treatment outcomes in diabetic ketoacidosis patients. Addressing and minimizing these factors could help reduce the incidence of poor treatment outcomes in diabetic ketoacidosis patients in Ethiopia.