Incidence and predictors of diabetic ketoacidosis among children with diabetes in West and East Gojjam zone referral hospitals Northern Ethiopia, 2019 (original) (raw)

Incidence and predictors of diabetic ketoacidosis among children with type 1 diabetes mellitus in Western Amhara Referral Hospitals, Northwestern Ethiopia, 2018: A Retrospective Follow-Up Study

2019

Background Diabetic ketoacidosis remains a major cause of morbidity, hospitalizations and mortality in children with established type 1 diabetes mellitus. Therefore, this study aimed to determine the incidence and predictors of diabetic ketoacidosis among children with established type 1 diabetes mellitus at Western Amhara region.Method Institution-based retrospective follow-up study was done on 393 children with established type 1 diabetes mellitus registered between September 2013 and September 2017 in Western Amhara referral hospitals. The collected data was entered into Epidata version 4.2 and further analysis were done using STATA version 14.1. Negative Binomial Poisson Regression analysis model was used.Result The cumulative incidence and incidence density rate of diabetic ketoacidosis among children with established type 1 diabetes mellitus in western Amhara referral hospitals was 63.9% and 41.5 per 100 person-years respectively. The incidence of diabetic ketoacidosis increas...

Clinical Characteristics of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes in Addis Ababa, Ethiopia: A Cross-Sectional Study

PloS one, 2017

Diabetic ketoacidosis (DKA) is one of the most serious acute complications of type 1 diabetes (T1D) and the leading cause of morbidity and mortality in children with T1D. This study was aimed at assessing the prevalence and associated factors of DKA in children with newly diagnosed T1D in Addis Ababa. A hospital based cross-sectional study was conducted in selected hospitals in Addis Ababa. Children below the age of 12 years with DKA who were admitted to the pediatric ward in the selected hospitals between January 2009 and December 2014 and the residence of Addis Ababa were included. DKA was defined as children below the age of 12 years who have blood glucose level ≥250mg/dl, ketonuria, and ketonemia and diagnosed being T1D patient for the first time. Descriptive statistics was performed using frequency distribution, mean, median, tables, and graphs. Logistic regression analysis was used to identify independent factors associated with the prevalence of DKA in children with newly dia...

Prevalence and Pattern of Diabetic Ketoacidosis among Children an Enugu, Southeast Nigeria: a 10 Year Retrospective Study

2021

Diabetic ketoacidosis (DKA) is the most severe complication in pediatric cases of type 1 diabetes and also the leading cause of death in these children. There is a broad geographic variation in the frequency of DKA at the onset of diabetes. This study sought to determine DKA's prevalence and pattern in Enugu and review the treatment and outcome over ten years. This retrospective study conduct in the Children Emergency Rooms (CHER) of the two tertiary institutions in Enugu State, southeast Nigeria: Enugu State University Teaching Hospital (ESUTH) and the University of Nigeria Teaching Hospital (UNTH). The biochemical criteria for the diagnosis of diabetic ketoacidosis (DKA) base on the presence of hyperglycemia (blood glucose > 11 mmol/L), acidosis (serum bicarbonate < 15 mmol/L), and ketonuria (urine ketone ≥1+). A total of 16,488 children were admitted during the ten years, of which 21 children presented with DKA, representing a prevalence of 0.13%. Six (28.6%) of the pat...

Diabetic Ketoacidosis in Children at the Mother and Child Academic Hospital, N’djamena Chad

OALib

Introduction: Diabetic ketoacidosis is the most common acute complication of diabetic children. Objective: To determine the frequency of diabetic ketoacidosis in children, describe the evolutionary profile, and identify factors associated with death. Patients and Method: A retrospective, descriptive, analytical study was conducted between January 2018 and November 2019. Children aged 5 to 15 years with a discharge diagnosis of diabetic ketoacidosis were included. Variables studied were age, sex, history of diabetes, clinical signs on admission, precipitating factors, blood glucose level, and outcome. The statistical test used was chi 2. Results: a total of 35 patients were admitted for ketoacidosis or 0.14%. They were boys n = 20 (57.1%) and girls n = 15 (42.9%) with a median age of 10.9 years. Children aged 10 to 15 years n = 26 (74%) were the most represented. The main clinical manifestations were kussmaul breathing n = 33 (94.5%), dehydration n = 27 (77%), and digestive disorders n = 26 (74%). Malaria 25 (71.4%) and urinary tract infection n = 15 (42.8%) were the triggering factors. Death was noted in 14 (40%) patients. Malaria (p: 0.03), children aged 10-14 years (p: 0.01), inaugural nature (p: 0.04) were associated with death. Conclusion: Diabetic ketoacidosis in children is relatively frequent, and the relative mortality is high. Its reduction requires early diagnosis. Also, communication for behaviour change and improving socioeconomic and cultural conditions are the axes of prevention.

Outcomes of Children and Adolescents Admitted with Diabetic Ketoacidosis at Kenyatta National Hospital (KNH), Kenya

Journal of Diabetes Research

Background. Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication that mainly occurs in patients with type 1 diabetes mellitus and is the foremost cause of death in these children. Overall mortality in children with DKA varies from 3.4% to 13.4% in developing countries. There is a need to understand outcomes among children with DKA in sub-Saharan African countries. Objective. To determine the death rate and clinical outcomes of children and adolescents aged 0-18 years managed for DKA at Kenyatta National Hospital (KNH). Study Methods. This was a retrospective study carried out among children aged 0–18 years admitted with DKA at KNH between February 2013 and February 2018. The study site was the central records department at KNH. The inclusion criteria were children aged 0-18 years admitted with a diagnosis of DKA based on the ISPAD guidelines biochemical criteria. Results. Out of the 159 files reviewed, the median age of children was 13 years (IQR 10-15). 41....

Frequency and Risk Factors of Diabetic Ketoacidosis in a Specialized Children’s Hospital, Riyadh: A Cross-sectional Study

Oman Medical Journal, 2021

Objectives: Diabetic ketoacidosis (DKA) is a life-threatening complication and a leading cause of hospitalization in patients with type 1 diabetes mellitus (T1DM). We aimed to assess the risk factors of admissions of children with DKA in a specialized children’s hospital to reduce morbidity and inform appropriate prevention and intervention strategies. Methods: We conducted a retrospective review of all DKA admissions at King Abdullah Specialized Children’s Hospital, Riyadh (March 2015–December 2017). Data were gathered from newly diagnosed patients with T1DM and known patients ≤ 14 years old with DKA criteria. The main variables were frequency, precipitating factors, and other characteristics of DKA admissions in both groups. Results: A total of 116/562 patients with T1DM (mean age 8.9±3.0 years) had 146 DKA episodes, of which 42/116 (36.2%) were newly diagnosed. The frequency of DKA admissions were 146/562 (26.0%), of which 42/141 (29.8%) were newly diagnosed versus 104/421 (24.7%...

Treatment Outcome of Diabetic Ketoacidosis Among Patients Atending General Hospital in North-West Ethiopia: Hospital Based Study

BackgroundDiabetic ketoacidosis is an acute life-threatening complication of diabetes mellitus. There was limited data on level of in-hospital mortality, hospital stay and factors associated with length of hospital stay among diabetic patients admitted to diabetic ketoacidosis at Debretabor General Hospital.ObjectiveThe aim of the study was to determine the length of hospital stay and in-hospital mortality of diabetic ketoacidosis patients and to assess determinants of long hospital stay among diabetic patients admitted with Diabetic ketoacidosis at Debretabor General Hospital.MethodA retrospective study was conducted at Debretabor General Hospital from June 1to 30, 2018. Participants included in the study were all diabetic patients with diabetic ketoacidosis admitted to the hospital from August 2010 to May 31, 2018 whose medical records contained complete pertinent data. The primary outcome was to determine the length of hospital stay and in-hospital mortality of diabetic ketoacido...

Managment of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: A review

East African Medical Journal, 2010

Background: Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes. Objective: To improve knowledge on the management of DKA in sub-Saharan Africa. Data sources: Literature review from different published sources. Data synthesis: Health systems in sub-Saharan Africa are currently organised for the treatment of episodes of illness and not long-term conditions like diabetes. Therefore the high rates of DKA is essentially due to lack of training of health professionals, lack of facilities in most hospitals, lack of public awareness as well as lack of health education to individual patients/families. In addition erratic insulin supply coupling with infections, low parental education, poor insulin storage and lack of facilities for self monitoring of blood glucose. Conclusion: A complex unfavourable social and economic environment is the basis of the high prevalence of DKA in sub-Saharan Africa. Several episodes of DKA can be prevented by effective public awareness programmes and education to healthcare providers.