Determinants of diabetes ketoacidosis among diabetes mellitus patients at North Wollo and Waghimra zone public hospitals, Amhara region, Northern Ethiopia

Addisu Getie,Adam Wondmieneh,Getnet Gedefaw,Melaku Bimerew,Asmamaw Demis

doi:10.1186/s12902-021-00692-y

Abstract

BackgroundDiabetes Mellitus (DM) is a metabolic disorder associated with acute and chronic complications. Diabetic ketoacidosis (DKA) is the most serious diabetic emergency in patients with type one and type two diabetes mellitus. It is the leading cause of mortality in children and young adults. Even though the burden of DKA has increased, no research has been conducted on the determinants of Diabetes ketoacidosis in Ethiopia, particularly in the Amhara region. Thus, this study aimed to identify the determinants of diabetes Ketoacidosis among Diabetes Mellitus patients at North Wollo and Waghimra Zone public Hospitals.MethodsAn institution-based unmatched case-control study design was employed among 408 patients at North Wollo and Waghimra Zone Public Hospitals from March 1st to April 30th, 2020. A consecutive sampling method was used to select study participants. The data were collected using structured interviewer-administered questioners and reviewing of patient charts. The analysis was done using a binary logistic regression model. Then, P-value < 0.05 was considered statistically significant.ResultThe mean (±SD) age of the study participants was 46.96 (± 15.175 SD) years. Irregular follow-up in diabetes clinic (AOR:4.19, 95% CI: 2.28–7.71), not received diabetic education (AOR: 2.87, 95% CI:1.44–5.72), alcohol drinking (AOR:2.99, 95% CI: 1.46–6.12), discontinuation of medications (AOR: 4.31, 95% CI:1.92–9.68), presence of comorbidity (AOR:2.57, 95% CI: 1.37–4.84), and being type one of diabetes mellitus (AOR: 2.01, 95% CI:1.11–3.63) were determinant factors of diabetic ketoacidosis .ConclusionsThis study showed that the behavioral and clinical characteristics of diabetic patients were determinant factors of DKA. Follow-up in the diabetic clinic, diabetic education, discontinuation of medications, alcohol drinking, presence of comorbidities, and type of diabetes mellitus were independent determinants of diabetic ketoacidosis.

Highlights

Diabetes Mellitus is a group of common metabolic disorders characterized by the presence of chronic hyperglycemia, which is accompanied by greater impairment in the metabolism of carbohydrates, lipids, and proteins [1]
Concerning the type of diabetes mellitus, patients with type one diabetes mellitus were 2.01 times more likely to develop diabetic ketoacidosis than patients with type two diabetes mellitus [alcohol drinking (AOR): 2.01; 95% Confidence Interval (CI) (1.11–3.63)] (Table 3). This institutional-based unmatched case-control study was conducted in North Wollo and Waghimra Zone public hospitals with diabetes mellitus patients to investigate the determinant factors of diabetic ketoacidosis
The reason might be due to patients who received education about diabetes mellitus can aware of the different blood glucose controlling mechanisms as they can prevent the occurrence of diabetic ketoacidosis

Summary

Introduction

Diabetes Mellitus is a group of common metabolic disorders characterized by the presence of chronic hyperglycemia, which is accompanied by greater impairment in the metabolism of carbohydrates, lipids, and proteins [1]. It is the leading cause of end-stage renal disease, traumatic lower extremity amputations, adult blindness, and predisposing to cardiovascular diseases [2]. Diabetic ketoacidosis (DKA) is the most serious diabetic emergency in patients with type one and type two diabetes mellitus It is the leading cause of mortality in children and young adults.

Objectives

Methods

Findings

Conclusion