Contributing Clinical Presentation, Risk Factors, and Outcomes for Diabetic Ketoacidosis Patients: A Single-Center Retrospective Study

Abstract

In patients with diabetes mellitus, diabetic ketoacidosis (DKA) is the most common acute metabolic complication and occurs more frequently in those with type 1 diabetes (DM1). DKA is a hyperglycemic crisis that develops due to insulin insufficiency. It can be due to insulin noncompliance, newly diagnosed diabetes mellitus, a subtherapeutic dose, and conditions that cause hyperglycemia leading to elevated ketone bodies (e.g., urinary/ respiratory tract infections), and some drugs. As reported by the World Health Organization in 2014, Saudi Arabia ranks seventh highest in the world for diabetes prevalence. The high prevalence of diabetes in Saudi Arabia contributes to the high incidence of patients with DKA. To evaluate the precipitating risks of DKA in diabetic patients and its clinical presentation and outcomes at King Faisal Hospital at Makkah in Saudi Arabia. A retrospective review of patients with (DM1) at King Faisal Hospital in Makkah who presented with DKA from September 2020 to February 2022 was performed. Symptoms and risk factors were compared across age and sex. We found that the symptoms of polyuria, nausea and vomiting, weight loss, and fever significantly differed at the 10% level depending on the patient's age. No signs were statistically significant concerning sex. Of the precipitating factors, patient failure to comply, inadequate insulin dose, and infections were statistically significant in the older age group. It was observed that missed insulin doses, high random blood sugar, and pH less than 7.3 were the most significant predictors of DKA recurrence.