Treatment outcomes of diabetic ketoacidosis among diabetes patients in Ethiopia. Hospital-based study

Eyob Gebreyohannes, Gizework Alemnew Mekkonen* (Corresponding Author), Kassahun Alemu Gelaye, Tadesse Melaku Abegaz

*Corresponding author for this work

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Abstract

Background
There was limited data on treatment outcomes among patients with diabetic ketoacidosis (DKA) in Ethiopia.

Objective
The aim of the study was to determine the treatment outcomes of DKA patients attending Debre Tabor General Hospital.

Method
A retrospective study was conducted at Debre Tabor General Hospital and data were collected from June 1 to June 30 of 2018. Participants included in the study were all diabetic patients with DKA admitted from August 2010 to May 31, 2018. The primary outcomes were the treatment outcomes of DKA including (in-hospital glycemic control, the length of hospital stay and in-hospital mortality). The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics was presented in the form of means with standard deviation and binary regression was conducted to determine factors that affect length of hospital stay among DKA patients.

Result
387 patients were included in the study. The mean age of patients was 33.30± 14.96 years. The most common precipitating factor of DKA was new onset diabetes mellitus 150(38.8%). The mean length of hospital stay was 4.64(±2.802) days. The mean plasma glucose at admission and discharge was 443.63(±103.33) and 172.94 (±80.60) mg/dL, respectively. The majority 370 (95.60%) of patients improved and discharged whereas 17 (4.40%) patients died in the hospital. Patients with mild and moderate DKA showed short hospital stay; AOR: 0.16 [0.03–0.78] and AOR:0.17[0.03–0.96] compared with severe DKA. Diabetic ketoacidosis precipitated by infection were nearly five times more likely to have long hospital stay than DKA precipitated by other causes; AOR: 4.59 [1.08–19.42]. In addition, serum glucose fluctuation during hospitalization increased the likelihood of long hospital stay, AOR: 2.15[1.76–2.63].

Conclusions
New onset type 1 diabetes was the major precipitating factor for DKA. Admitted DKA patients remained in hospital for a duration of approximately five days. About five out of hundred DKA patients ended up with death in the hospital. Infection, serum glucose fluctuations and severity of DKA were determinants of long hospital stay. Early prevention of precipitating factors and adequate management of DAK are warranted to reduce length of hospital stay and mortality.
Original languageEnglish
Article numbere0264626
Number of pages15
JournalPloS ONE
Volume17
Issue number4
Early online date5 Apr 2022
DOIs
Publication statusPublished - 5 Apr 2022

Bibliographical note

Acknowledgments
The authors would like to acknowledge University of Gondar and Debre Tabor General Hospital for the overall support. Part of this manuscript was presented as a preprint to research square and bioRxiv but not published in any journal.

Funding
This study did not receive funding.

Data Availability Statement

All relevant data are within the paper and its Supporting Information files.

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