Recurrent diabetic ketoacidosis in Saudi patients with type 1 diabetes mellitus: a retrospective study from a tertiary hospital

BACKGROUND:
Diabetic ketoacidosis (DKA) is a potentially fatal complication of type 1 diabetes mellitus (T1DM). To our knowledge, limited studies have examined the risk factors of recurrent DKA in the Saudi T1DM population.


OBJECTIVES:
To identify factors contributing to recurrent DKA in Saudi patients with T1DM. By identifying the contributing factors for DKA recurrence the disease burden can be mitigated by making targeted interventions.


DESIGN:
Retrospective


SETTING:
Tertiary care center, Jeddah, Saudi Arabia


PATIENTS AND METHODS:
Saudi patients with T1DM admitted with DKA between 2021 to 2023 were included. A comparative analysis was performed between patients with a single recurrence of DKA and those with multiple recurrent admissions.


MAIN OUTCOME MEASURES:
Association between multiple variables and recurrent DKA.


SAMPLE SIZE:
245 Saudi patients with T1DM


RESULTS:

A total of 245 Saudi patients with T1DM were included. A significantly higher proportion of females were observed in the multiple recurrent DKA group (73.1% vs. 48.5%,
P
=.0001). Also, a higher proportion of single individuals were found among the multiple recurrent DKA group (
P
=.006). Longer duration of T1DM (≥5 years) and presence of microalbuminuria were more associated with multiple recurrent DKA than single recurrence of DKA. Among the precipitating factors, non-adherence to medications was associated with multiple recurrence of DKA (
P
=.02).



CONCLUSION:
This study has identified several risk factors contributing to recurrent DKA episodes among Saudi patients with T1DM. By increasing awareness of these factors among both healthcare providers and the community, we can develop more effective prevention strategies and ultimately reduce the incidence of recurrent DKA.


LIMITATIONS:
A retrospective study and single-center experience.