FREQUENCY OF DIABETIC KETOACIDOSIS AND ITS DETERMINANTS AMONG ADULT DIABETES MELLITUS PATIENTS ON FOLLOW-UP AT ADDIS ZEMEN PRIMARY HOSPITAL, NORTHWEST ETHIOPIA, 2024.

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