Epidemiological Pattern and Precipitating Factors of Diabetic Ketoacidosis: A Retrospective Study at King Fahad Specialist Hospital, Buraidah, Saudi Arabia.
Diabetic ketoacidosis (DKA) is an acute and severe complication of diabetes that results in increased morbidity and utilization of healthcare resources. Understanding the local patterns and triggers of DKA is important for improving prevention and patient care. This study aimed to assess the epidemiological features and precipitating factors of DKA and evaluate their association with disease severity and time to DKA resolution.
A retrospective review of 193 patients with DKA admitted to King Fahad Specialist Hospital, Buraydah, Saudi Arabia, from 2023 to 2025 was conducted. Demographic, clinical, biochemical, and etiological variables were analyzed. Associations between DKA severity and resolution time were assessed using the chi-square test, t-test, ANOVA, and multivariate logistic regression.
Most patients were young, with 90 patients (46.6%) aged <18 years. Moderate DKA was the most frequent presentation, affecting 114 patients (59.1%), followed by mild DKA in 51 patients (26.4%) and severe DKA in 28 patients (14.5%). The mean HbA1c level was 11.9%. Missing insulin doses were the main trigger for DKA in 122 patients (63.2%), followed by respiratory tract infections in 21 patients (10.9%) and newly diagnosed diabetes and not on any medications in 16 patients (8.3%). Severe DKA was associated with lower pH, lower bicarbonate, higher anion gap, higher glucose, more pronounced electrolyte abnormalities, and longer resolution times. The etiology of DKA was not significantly associated with severity (p = 0.644) or duration of resolution (p = 0.052); however, infection-related etiologies showed a trend toward longer recovery times.
Although missing insulin doses were the leading trigger for DKA, precipitating etiology did not significantly influence DKA severity or recovery duration. There was no statistically significant relationship between age, chronic diseases, and DKA severity based on the adjusted regression model. DKA severity was the primary determinant of prolonged resolution time. Strengthening adherence, early diagnosis, and risk‑stratified management is essential to reduce the burden of DKA.
A retrospective review of 193 patients with DKA admitted to King Fahad Specialist Hospital, Buraydah, Saudi Arabia, from 2023 to 2025 was conducted. Demographic, clinical, biochemical, and etiological variables were analyzed. Associations between DKA severity and resolution time were assessed using the chi-square test, t-test, ANOVA, and multivariate logistic regression.
Most patients were young, with 90 patients (46.6%) aged <18 years. Moderate DKA was the most frequent presentation, affecting 114 patients (59.1%), followed by mild DKA in 51 patients (26.4%) and severe DKA in 28 patients (14.5%). The mean HbA1c level was 11.9%. Missing insulin doses were the main trigger for DKA in 122 patients (63.2%), followed by respiratory tract infections in 21 patients (10.9%) and newly diagnosed diabetes and not on any medications in 16 patients (8.3%). Severe DKA was associated with lower pH, lower bicarbonate, higher anion gap, higher glucose, more pronounced electrolyte abnormalities, and longer resolution times. The etiology of DKA was not significantly associated with severity (p = 0.644) or duration of resolution (p = 0.052); however, infection-related etiologies showed a trend toward longer recovery times.
Although missing insulin doses were the leading trigger for DKA, precipitating etiology did not significantly influence DKA severity or recovery duration. There was no statistically significant relationship between age, chronic diseases, and DKA severity based on the adjusted regression model. DKA severity was the primary determinant of prolonged resolution time. Strengthening adherence, early diagnosis, and risk‑stratified management is essential to reduce the burden of DKA.
Authors
Alharbi Alharbi, Alsaawi Alsaawi, Aljumaah Aljumaah, Alkhulayfi Alkhulayfi, Alharbi Alharbi, Alharbi Alharbi
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