Abstract:
Background: Diabetic ketoacidosis is an acute life-threatening complication of
diabetes mellitus characterized by the triad of hyperglycemia, acidosis, and ketosis
that occurs in the presence of very low levels of effective insulin action. Even though
the prevalence of diabetic ketoacidosis has dramatically increased recently, little is
known or studied about the determinant factors for the development of recurrent
diabetic ketoacidosis among diabetics.
Objective: To determine the frequency of diabetic ketoacidosis and to identify its
determinants among adult diabetic patients on follow-up at Addis Zemen primary
Hospital, Northwest Ethiopia, 2024.
Methods: An institution based retrospective follow-up study was conducted from
June 1st to 30th 2024. The data was collected from randomly selected 417 medical
charts of diabetic patients. To determine the association of covariates with the
frequency of Diabetic Ketoacidosis (DKA) zero-inflated negative binomial model was
fitted. Akakies information criterion (AIC) was used for model comparison and zero inflated negative binomial model was fitted. In the multivariable analysis p-value less
than 0.05 and an adjusted incidence rate ratio (AIRR) with 95% CI were used to
declare statistically significant predictors.
Result: Out of 417 adult DM patients included in the study 278(66.67%) of them had
developed DKA at least once during the study period. The mean frequency of DKA
was 1.26 per individual. The incidence rate of DKA was increased among DM
patients with history of infection (AIRR=3.9, 95% CI= 1.63 – 7.88), with history of
missed DM follow up (AIRR=2.85, 95% CI= 1.10 – 5.41) and among those who take
inadequate dose of medication (AIRR=1.25, 95% CI= 1.02 – 1.53).
Conclusion: Having infection, missed DM follow up and taking inadequate dose of
DM medications were the factors that increase the frequency of DKA among adult
DM patients
