Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study

Abstract Introduction Diabetic ketoacidosis is an acute complication of diabetes mellitus that is characterised by hyperglycemia, acidosis, and ketonuria. Diabetes is the most challenging public health problem in the twenty-first century for both developed and developing countries. Objective To asse...

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Main Authors: Beyene Zewdu, Tefera Belachew, Kemal Ahmed, Lehulu Tilahun, Kirubel Dagnaw
Format: Article
Language:English
Published: BMC 2024-03-01
Series:BMC Endocrine Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12902-024-01552-1
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author Beyene Zewdu
Tefera Belachew
Kemal Ahmed
Lehulu Tilahun
Kirubel Dagnaw
author_facet Beyene Zewdu
Tefera Belachew
Kemal Ahmed
Lehulu Tilahun
Kirubel Dagnaw
author_sort Beyene Zewdu
collection DOAJ
description Abstract Introduction Diabetic ketoacidosis is an acute complication of diabetes mellitus that is characterised by hyperglycemia, acidosis, and ketonuria. Diabetes is the most challenging public health problem in the twenty-first century for both developed and developing countries. Objective To assess the incidence of Diabetic ketoacidosis and its determinants among adult people with diabetes at an Ethiopian Hospital. Method An institution-based retrospective cohort study was conducted among 390 adult people with diabetes attending services at Wolida Comprehensive Specialized Hospital. The consecutive sampling method was used to select study participant charts. Data were collected using a checklist prepared from different literature. The data were entered into EPI data version 4.6.0.5 and exported to STATA version 14.0 for further analysis. The Wiebull model was the best fitted model that was selected using the log-likelihood ratio method and the Akakian information criterion. Hazard ratios with their 95% confidence interval and p-value were computed. Result From the total 405 charts reviewed, 390 adult charts were included for analysis. A total of 121 DKA occurred from 5471 person–months of observation. The overall incidence rate of diabetic ketoacidosis was found to be 2.2 per 100 person-months (95% CI: 1.8- 2.6). Being urban dweller (AHR: 0.59, 95% CI: 0.36–0.99), having no family history of DM (AHR: 0.55, 95%CI: 0.31—0.97), presence of infection (AHR: 2.60, 95%CI = 1.06–6.39), having of any comorbidities (AHR: 4.31, 95% CI: 1.70–10.90), and having poor glycemic control (AHR: 7.45, 95% CI: 3.84–14.47) were significant determinants. Conclusion and recommendations The overall incidence of diabetic ketoacidosis in study area was relatively high. Poor glycemic control, the presence of infection, and comorbidity were determinants of diabetic ketoacidosis. There is a need to have close follow-up of people with diabetes who have comorbidity, infection, and poor glycemic control.
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spelling doaj.art-bc4c50687e0744578f39795293db86302024-03-17T12:28:46ZengBMCBMC Endocrine Disorders1472-68232024-03-012411910.1186/s12902-024-01552-1Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort studyBeyene Zewdu0Tefera Belachew1Kemal Ahmed2Lehulu Tilahun3Kirubel Dagnaw4Department of Nursing, Raya Kobo Primary HospitalCollege of Medicine and Health Sciences, Jimma UniversitySchool of Public Health, College of Medicine and Health Sciences, Wollo UniversityDepartment of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Comprehensive Nursing, College of Medicine and Health Sciences, Wollo UniversityAbstract Introduction Diabetic ketoacidosis is an acute complication of diabetes mellitus that is characterised by hyperglycemia, acidosis, and ketonuria. Diabetes is the most challenging public health problem in the twenty-first century for both developed and developing countries. Objective To assess the incidence of Diabetic ketoacidosis and its determinants among adult people with diabetes at an Ethiopian Hospital. Method An institution-based retrospective cohort study was conducted among 390 adult people with diabetes attending services at Wolida Comprehensive Specialized Hospital. The consecutive sampling method was used to select study participant charts. Data were collected using a checklist prepared from different literature. The data were entered into EPI data version 4.6.0.5 and exported to STATA version 14.0 for further analysis. The Wiebull model was the best fitted model that was selected using the log-likelihood ratio method and the Akakian information criterion. Hazard ratios with their 95% confidence interval and p-value were computed. Result From the total 405 charts reviewed, 390 adult charts were included for analysis. A total of 121 DKA occurred from 5471 person–months of observation. The overall incidence rate of diabetic ketoacidosis was found to be 2.2 per 100 person-months (95% CI: 1.8- 2.6). Being urban dweller (AHR: 0.59, 95% CI: 0.36–0.99), having no family history of DM (AHR: 0.55, 95%CI: 0.31—0.97), presence of infection (AHR: 2.60, 95%CI = 1.06–6.39), having of any comorbidities (AHR: 4.31, 95% CI: 1.70–10.90), and having poor glycemic control (AHR: 7.45, 95% CI: 3.84–14.47) were significant determinants. Conclusion and recommendations The overall incidence of diabetic ketoacidosis in study area was relatively high. Poor glycemic control, the presence of infection, and comorbidity were determinants of diabetic ketoacidosis. There is a need to have close follow-up of people with diabetes who have comorbidity, infection, and poor glycemic control.https://doi.org/10.1186/s12902-024-01552-1Incidence rateDeterminantsDiabetic ketoacidosisEthiopia
spellingShingle Beyene Zewdu
Tefera Belachew
Kemal Ahmed
Lehulu Tilahun
Kirubel Dagnaw
Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
BMC Endocrine Disorders
Incidence rate
Determinants
Diabetic ketoacidosis
Ethiopia
title Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
title_full Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
title_fullStr Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
title_full_unstemmed Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
title_short Incidence and determinants of diabetic ketoacidosis among people with diabetes in Woldiya comprehensive specialized hospital, Ethiopia: a retrospective cohort study
title_sort incidence and determinants of diabetic ketoacidosis among people with diabetes in woldiya comprehensive specialized hospital ethiopia a retrospective cohort study
topic Incidence rate
Determinants
Diabetic ketoacidosis
Ethiopia
url https://doi.org/10.1186/s12902-024-01552-1
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