Predictive factors of ketoacidosis in type 1 diabetes mellitus

Abstract

Background Diabetic ketoacidosis (DKA) is an acute complication in type 1 diabetes mellitus (DM) and a significant cause of morbidity and mortality in developing countries. Diabetic ketoacidosis can be prevented by good management of the disease. Risk factors from previous studies that increase the DKA incidence were peripubertal age, female gender, low socio-economic status, low parental education status, DKA at the first diagnosis of type 1 DM, infection, psychological problems, poor metabolic control, and non-compliance with insulin treatment.
 Objective To determine whether sex, age, socio-economic status, parental education level, DKA at the initial diagnosis of type 1 DM, infection, psychological problems, poor metabolic control, and failing to take insulin as needed were predictive of DKA in type 1 DM patients.
 Methods We conducted a retrospective cohort study using medical records from type 1 DM patients aged 0-20 years, at the Department of Child Health, Dr. Sardjito Hospital, Yogyakarta, from January 2011 to May 2017. We assessed for the incidence and predictors of DKA. Logistic regression analysis was done to determine which factors increased DKA incidence.
 Results A total of 57 type 1 DM patients were recruited, with DKA incidence of 37 (65%). Five (8.8%) DKA patients died. Multivariate analysis revealed that infection (OR 5.23; 95%CI 1.47 to 19.68; P=0.014) and DKA at the first diagnosis of type 1 DM (OR 5.37; 95%CI 1.40 to 19.52; P=0.011) were significant risk factors for DKA. 
 Conclusion Infection and DKA at the first diagnosis of type 1 DM are significant predictors of increased DKA incidence.

Diabetic Ketoasidosis

“…Based on medical record data from RSUP dr. Sardjito in Yogyakarta, it was found that the Dela Serlina/KESANS Diabetic Ketoacidosis prevalence of DKA in the 2014-2016 period was 62.5%. (Listianingrum, Patria, and Wibowo 2019)…”

Severe diabetic ketoacidosis with cerebral edema and acute kidney failure: a case report

“…4 Compared to developed countries which is only 0.15 -0.31%, mortality related to DKA in developing countries is quite high, namely 3.4 -13.4%. 4 In 2017, 71% of children with DMT1 were first diagnosed with DKA. 4 This figure increased between 2015 and 2016 which was around 63%.…”

“…1 Diabetic ketoacidosis (DKA) is one of the acute complications of DMT1. 4 This situation causes significant morbidity and mortality in people with DMT1. 4 Compared to developed countries which is only 0.15 -0.31%, mortality related to DKA in developing countries is quite high, namely 3.4 -13.4%.…”

“…4 This situation causes significant morbidity and mortality in people with DMT1. 4 Compared to developed countries which is only 0.15 -0.31%, mortality related to DKA in developing countries is quite high, namely 3.4 -13.4%. 4 In 2017, 71% of children with DMT1 were first diagnosed with DKA.…”

“…4 In 2017, 71% of children with DMT1 were first diagnosed with DKA. 4 This figure increased between 2015 and 2016 which was around 63%. 1 The problem is the lack of awareness of the community and health workers, so many patients escape diagnosis and do not get adequate treatment.…”