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. 2020 Nov 3;46(1):164.
doi: 10.1186/s13052-020-00930-4.

Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east Gojjam zone referral hospitals, northern Ethiopia, 2019

Birtukan Assefa  1 , Haymanot Zeleke  2 , Rajalakshmi Murugan  3 , Kalkidan Wondwossen  3
Affiliations

Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east Gojjam zone referral hospitals, northern Ethiopia, 2019

Birtukan Assefa et al. Ital J Pediatr. .

Abstract

Background: Recurrent diabetic ketoacidosis in patients with known diabetes mellitus remains a relevant problem in pediatrics with an incidence of 1-10% per patient. Children may die because of cerebral edema and had a significant mortality (24%) and morbidity (35%).

Objective: We assessed the incidence and predictors of diabetic ketoacidosis among diabetes children at East and West Gojjam zone referral hospitals, North West Ethiopia, 2019.

Methods: An institution-based retrospective follow up study was conducted on children who were registered from January 1, 2014, to January 1, 2019. Epi data version 3.1 & Stata 14 were used for data entering and analysis respectively.

Result: Out of 354 children included in the study, 207 (58.5%) developed diabetic ketoacidosis. The overall incidence rate of diabetic ketoacidosis was 2.27/100 children/month of observation. Age < 5 years (AHR: 3.52, 95% CI (2.25, 5.49), non-adherence (AHR: 1.54, 95% CI (1.11, 2.14), inappropriate insulin storage (AHR: 1.36, 95% CI (1.008, 1.85), presence of upper respiratory tract infections during diabetic ketoacidosis diagnose (AHR: 2.22, 95% CI (1.11, 4.45) and preceding gastroenteritis (AHR: 2.18, 95% CI (1.07, 4.44) were significant predictors.

Conclusion: Age < 5 years old, non-adherence, inappropriate insulin placement at home, preceding gastroenteritis, and presence of upper respiratory tract infections at the time of diabetic ketoacidosis development were significant predictors. Hence, assessing and close monitoring as well as strengthened diabetic education should be given for the above predictors.

Keywords: And children; Diabetic ketoacidosis; Diabetic mellitus; Incidence.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Present acute illness at the time of DKA diagnose children at East &West Gojjam zone referral hospitals, Northwest Ethiopia, 2019
Fig. 2
Fig. 2
Comorbidities among DM diagnosed children at East &West Gojjam zone referral hospitals, Northwest Ethiopia, 2019
Fig. 3
Fig. 3
The hazard estimate of DKA after DM diagnosed children at East &West Gojjam zone referral hospitals, Northwest Ethiopia, 2019
Fig. 4
Fig. 4
Kaplan-Meier survival estimate of DKA occurrence based on insulin placement at home at East &West Gojjam zone referral hospitals, North West Ethiopia, 2019
Fig. 5
Fig. 5
Kaplan-Meier survival estimate of DKA occurrence based on medication adherence at East &West Gojjam zone referral hospitals, North West Ethiopia, 2019
See this image and copyright information in PMC

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