Time to recovery from diabetic ketoacidosis and its predictors among children with type 1 diabetes at selected governmental hospitals in Addis Ababa, Ethiopia, 2023: retrospective follow-up study
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Date
2023
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Addis Ababa University
Abstract
Background: Diabetic ketoacidosis (DKA) is one of the most severe clinical features of diabetes
mellitus, which can result in morbidity and mortality. The prevalence of DKA is increasing
worldwide and nationwide. There is a discrepancy of time to recovery from DKA between
developed and developing country. The Ethiopian government aims to decrease premature
mortality from noncommunicable diseases, including diabetes, by one-fourth by 2025. To achieve
this target plan, more research should be conducted in this area.
Objective: To assess time to recovery from DKA and its predictor among children with diabetic
ketoacidosis at selected governmental hospitals in Addis Ababa, Ethiopia, 2023
Methods: A five years retrospective follow-up study design was employed among 391 children
admitted with DKA to selected governmental hospitals in Addis Ababa, Ethiopia from January 1,
2018 to December 30, 2022. Simple random sampling technique was used to select the hospitals
and participants. Preliminary survey of the study hospitals was done to determine flow and the
sample was proportionally allocated. Structured data collection checklist was adapted from similar
studies in the literature. Data was checked for completeness, and exported into Stata version 16
for analysis. A variable with P value < 0.05 in the multivariate Cox proportional hazards model
was considered as significant predictors of time to recovery from DKA.
Results: a total of 391 (92.4%) children with DKA were included in the final analysis. Out of
these 370, recovered and discharged. The left 21 cases were censored. The overall median time
taken for resolution of DKA was 27hrs, IQR (16-38). DM history (AHR=0.41, 95% CI:0.30-0.56),
severity of DKA (AHR=2.35, 95% CI:1.36-4.1), presence of comorbidity (AHR=1.76, 95%
CI:1.37-2.26), and blood sugar level were (AHR= 0.61, 95% CI:0.39-0.96) all independent
predictors of time to recovery from DKA.
Conclusion: Though the total median time to recovery from DKA was in the accepted range
(<36hrs), it was significantly associated by the identified predictors in this study. Thus, increasing
public awareness on symptoms of DKA, giving emphasis, enhancing quality of care, prioritize and
treating children with identified predictors is important.
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Keywords
Diabetes, diabetic ketoacidosis, recovery time, children