Prevalence and associated factors of diabetic ketoacidosis among patients with diabetes mellitus at the University of Gondar Comprehensive and Specialized Referral Hospital Northwest, Ethiopia

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Pubblicato in:PLoS One vol. 20, no. 2 (Feb 2025), p. e0318775
Autore principale: Abebe Birhanu
Altri autori: Ambachew, Sintayehu, Baye, Netsanet, Emiyamrew Getnet, Admas, Sintayehu, Eshet Gebrie, Worede, Abebaw
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022 |a 1932-6203 
024 7 |a 10.1371/journal.pone.0318775  |2 doi 
035 |a 3165334975 
045 2 |b d20250201  |b d20250228 
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100 1 |a Abebe Birhanu 
245 1 |a Prevalence and associated factors of diabetic ketoacidosis among patients with diabetes mellitus at the University of Gondar Comprehensive and Specialized Referral Hospital Northwest, Ethiopia 
260 |b Public Library of Science  |c Feb 2025 
513 |a Journal Article 
520 3 |a BackgroundDiabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetic ketoacidosis is one of the life-threatening complications in diabetic individuals with, high morbidity and mortality globally. However, the data related to the prevalence and associated factors of diabetic ketoacidosis are limited in the study setting.ObjectiveTo assess the prevalence of diabetic ketoacidosis and its associated factors among diabetic mellitus patients at the University of Gondar Comprehensive Specialized Hospital.MethodsA hospital-based cross-sectional study was conducted from March 1 to September 30, 2021. A total of 405 diabetic patients aged 20 and above were selected using a systematic random sampling technique. A total of 810 blood and urine samples (each 405) were collected using sterile serum separator tubes and urine collection cups, respectively. Sociodemographic and clinical data was collected using a structured questionnaire. Chemical analysis of urine was done using urine reagent strips to determine urine ketone bodies and PH. BECKMAN COULTER DxC700 AU clinical chemistry analyzer instrument was used to determine electrolytes and metabolites. The data was entered using Epi-Data version 4.6 and transferred to SPSS version 25 for analysis. Bivariable and multivariable logistic regression analyses were used to determine the factors associated with the diabetic ketoacidosis. The results were considered statistically significant if the adjusted odds ratio was reported with a 95% confidence interval and a P-value below 0.05.ResultsThe overall prevalence of diabetic ketoacidosis among diabetic patients was 35/405 (8.6%, 95% CI: 6.0–11.0%). Of these cases, 25 (71.4%) had type 1 diabetes mellitus, while 10 (28.6%) had type 2 diabetes mellitus. Statistically significant factors associated with diabetic ketoacidosis included being a young adult aged 20–29 years (AOR = 2.262; 95% CI = 1.090–4.758; P = 0.013), unemployment (AOR = 2.578; 95% CI = 1.457–6.113; P = 0.017), the presence of infection (AOR = 2.819; 95% CI = 1.138–8.428; P = 0.024), and being T1DM (AOR = 3.106; 95% CI = 1.150–7.273; P = 0.003).Conclusions and recommendationsThe prevalence of diabetic ketoacidosis among follow-up diabetes patients in this study was high, particularly among those aged 20–29 years, unemployed, or with infections. Increased vigilance, regular monitoring, timely infection management, and comprehensive diabetes education are essential for early detection and prevention of DKA. Social and financial support for unemployed diabetic patients can further enhance access to care and reduce DKA risk. 
610 4 |a University of Gondar 
651 4 |a Ethiopia 
653 |a Chemical analysis 
653 |a Insulin secretion 
653 |a Young adults 
653 |a Regression analysis 
653 |a Tubes 
653 |a Metabolites 
653 |a Metabolism 
653 |a Urine 
653 |a Random sampling 
653 |a Sampling techniques 
653 |a Metabolic disorders 
653 |a Data analysis 
653 |a Sample size 
653 |a Diabetes mellitus (insulin dependent) 
653 |a Hospitals 
653 |a Statistical sampling 
653 |a Patients 
653 |a Insulin 
653 |a Ketoacidosis 
653 |a Infections 
653 |a Diabetes mellitus (non-insulin dependent) 
653 |a Insulin resistance 
653 |a Diabetes 
653 |a Morbidity 
653 |a Hyperglycemia 
653 |a Fatty acids 
653 |a Statistical significance 
653 |a Statistical analysis 
653 |a Ketones 
653 |a Diabetic ketoacidosis 
653 |a Reagents 
653 |a Electrolytes 
653 |a Surgery 
653 |a Sampling methods 
653 |a Confidence intervals 
653 |a Sociodemographics 
653 |a Glucose 
653 |a Variables 
653 |a Diabetes mellitus 
653 |a Vigilance 
653 |a Social 
700 1 |a Ambachew, Sintayehu 
700 1 |a Baye, Netsanet 
700 1 |a Emiyamrew Getnet 
700 1 |a Admas, Sintayehu 
700 1 |a Eshet Gebrie 
700 1 |a Worede, Abebaw 
773 0 |t PLoS One  |g vol. 20, no. 2 (Feb 2025), p. e0318775 
786 0 |d ProQuest  |t Health & Medical Collection 
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