Risk Factors for Diabetic Ketoacidosis among Type 1 Diabetic Children Registered at “Heraa Diabetes Center” in Makkah Al-Mokarramah City, Saudi Arabia

Abstract

Aim of Study: To assess risk factors associated with DKA among T1DM children registered at “Heraa Diabetes Center”, Makkah Al-Mokarramah City, Saudi Arabia. Patients and Methods: A retrospective hospital-based, case-control research design was followed and included 375 diabetic patients aged less than 15 years. The “Study Group” included 125 children who had a past history of diabetic ketoacidosis (DKA Group), while the “Control Group” comprised 250 diabetic children who did not have past history of DKA. A data collection sheet was designed by the researchers. Results: There was significantly more positive family history in the DKA group than the control group (78.4% and 68%, respectively, p=0.036). The mothers were the main person who injects the child. Differences between both study groups according to the person who injects the child was statistically significant (p=0.029). DKA occurred more than once in 59.2% of diabetic children, and in 46.4% of children with over-activity. The main presenting symptoms of DKA were polyuria, thirst and vomiting. The main causes and triggering factors were eating too many sweets (65.6%), missing blood sugar monitoring (57.6%), omitting the insulin dose (22.4%), or infection (12.8%). Children in the control group were significantly more compliant than those in the DKA group regarding daily measurement of blood sugar (82.8% and 71.2%, respectively, p=0.009), timely receiving treatment (96% and 82.4%, respectively, p<0.001), following a healthy diet (79.6% and 65.6%, respectively, p=0.003), and receiving health education (95.2% and 88%, respectively, p=0.011). Conclusions: Risk factors for DKA include positive family history of diabetes, and less educated or employed mothers, but its incidence is lower among children of parents with health-related jobs. It can be triggered by over-activity. It is caused by eating too many sweets, missing blood sugar monitoring, omitting the insulin dose, or infection. Noncompliance is associated with higher incidence of DKA. Recommendations: All parents of diabetic children should receive health education and be trained about management of diabetes, compliance to diabetes management, continuous monitoring of glucose levels, and early manifestations of DKA. Key Words: Diabetic ketoacidosis, Type 1 diabetes, Children, Risk factors, Compliance, Saudi Arabia.