A Retrospective Study of The Prevalence of Diabetic Ketoacidosis in Saudi Adolescents and Adults with Type 1 Diabetes

Objectives: To assess the frequency and predictors of diabetic ketoacidosis (DKA) in adolescents and adults with type 1 diabetes (T1DM). Methodology: This retrospective analysis involved patients over the age of 12 who were monitored at the endocrine clinic of King Abdulaziz Medical City in Riyadh from July 2019 to July 2020. A comparison was made between patients with diabetic ketoacidosis (DKA) and those without, utilizing the chi-squared test or Fisher's exact test for categorical variables and the t-test or Kruskal-Wallis test for continuous variables. Independent risk factors were determined through multivariate logistic regression analysis. Results: Among the 262 patients diagnosed with Type 1 Diabetes Mellitus (T1DM), 56.1% were female, with an average age of 22.6 years (+/- 8.07). Approximately 58% of these patients reported a history of diabetic ketoacidosis (DKA), and 46.9% experienced DKA at the time of diagnosis. The average glycated hemoglobin level recorded was 9.0% (+/- 1.80). Missing appointments at the endocrine clinic was linked to increased hospital admissions due to DKA. Of those with a DKA history, 81.6% experienced it once annually, while 18.4% had multiple hospitalizations. The average age of patients during admission was 18.1 years (+/- 7.33), with an average hospital stay of 2.9 days (+/- 1.53). Although most DKA episodes were classified as mild to moderate, 19.7% were severe. The primary reason for DKA was identified as noncompliance with insulin therapy, accounting for 52% of cases. Conclusions: DKA is frequently observed in individuals with T1DM in Saudi Arabia, largely attributed to nonadherence to insulin therapy. Around one-third of these patients encounter recurrent or severe episodes of DKA. It is advisable to engage in regular conversations regarding insulin adherence and the management of illness-related complications.