MW. Aynalem, B. Nigusse, Y. Legesse, DG. Abebe, T. Ayele, H. Getachew, AM. Haile, et al. (2026). Clinical profile of diabetic ketoacidosis and its severity in adults: evidence from ALERT Comprehensive Specialized Hospital. BMC endocrine disorders, 26(1). https://doi.org/10.1186/s12902-026-02224-y

PubMed 41794693

[Abstract]
BACKGROUND: Diabetic Ketoacidosis (DKA) is one of the most common acute complications of patients diagnosed with Diabetes mellitus. We aimed to assess clinical characteristics, severity of DKA and factors associated with DKA among adult patients admitted at the emergency unit of ALERT Comprehensive Specialized Hospital.

METHODS: A cross-sectional hospital-based study was used. DKA severity was assessed using a modified version of Joint British Diabetes Societies (JBDS) 2023 guideline. SPSS version 27 was used for data analysis.

RESULTS: Of 422 patients with DKA, 60.7% were male. The mean age of the participants was 38.9(± 16.6) year. About a third (35.8%) of DKA cases were known type 2 DM patients. Underlining infection (33.4%) was the principal DKA precipitating factor. Based on modified JBDS criteria, 55% of the study participants had severe DKA. Tachycardia (23%) was the most frequently observed DKA severity criteria, followed by pH < 7.0. The frequency of DKA events in the majority of patients was reported only once (87%). About 32.9% of study participants had a urine ketone level of + 2. The odds of severe DKA were two times higher among female patients; AOR: 2.1 [1.40-3.19] while the presence of comorbidity reduces DKA severity by 50%; AOR: 0.50 [0.34-0.75].

CONCLUSION: This study found that over half of the participants had severe DKA. Early identification and management of infections in patients with diabetes are crucial to prevent severe DKA. Female gender was found to be an associated factor for severity.

CLINICAL TRIAL NUMBER: Not applicable.