A. Bayih, Z. Abebe, A. Hailu and YS. Bizu (2026). Time to Resolution of Diabetic Ketoacidosis and Its Predictors among Adult Diabetic Patients in Public Hospitals of Northeast, Ethiopia. Scientific reports, 16(1). https://doi.org/10.1038/s41598-026-47657-6

PubMed 41936720

[Abstract]
Despite the discovery and development of diagnostic tests, medications, and technologies, diabetic ketoacidosis remains one of the leading causes of morbidity and mortality among patients with diabetes. Therefore, this study aimed to determine the time to resolution of diabetic ketoacidosis and its predictors among adult diabetic patients in public hospitals of the North Shoa Zone, Northeast Ethiopia. A retrospective follow-up study was conducted among 340 patients with complete medical records from February 1, 2021, to February 1, 2024. Data were analyzed using STATA version 16. Kaplan–Meier survival curves and the log-rank test were used to assess differences in survival among groups. The proportional hazards assumption was evaluated using Schoenfeld residuals, and model fitness was assessed using the Cox–Snell residual test. Cox proportional hazards regression analysis was performed to identify predictors of time to resolution of diabetic ketoacidosis among adult diabetic patients. Variables with a p-value < 0.25 in the bivariable analysis were included in the multivariable model, and predictors were considered statistically significant at p < 0.05 with a 95% confidence interval. The median time to resolution of diabetic ketoacidosis (DKA) among the 340 participants was 14 h (95% CI: 13–16). Age groups 45–54 years (AHR = 0.47; 95% CI: 0.28–0.79) and ≥ 55 years (AHR = 0.24; 95% CI: 0.12–0.45), moderate DKA (AHR = 0.23; 95% CI: 0.16–0.32), severe DKA (AHR = 0.10; 95% CI: 0.06–0.17), and initial random blood sugar > 500 mg/dL (AHR = 0.49; 95% CI: 0.36–0.65) were significantly associated with a slower time to DKA resolution. In contrast, having type 2 diabetes mellitus (AHR = 4.20; 95% CI: 2.42–7.34), a duration of diabetes mellitus > 5 years (AHR = 6.65; 95% CI: 2.50–17.76), and not being newly diagnosed (AHR = 6.45; 95% CI: 2.42–17.18) were significantly associated with a faster time to DKA resolution. The median time to resolution of diabetic ketoacidosis (DKA) was 14 h. Age greater than 45 years, moderate to severe diabetic ketoacidosis, high initial blood glucose levels, and newly diagnosed diabetes were associated with slower resolution. In contrast, type 2 diabetes, duration of diabetes mellitus greater than 5 years, and not being newly diagnosed were associated with faster resolution. Consequently, early risk stratification and targeted management may improve DKA outcomes.