Incidence and predictors of diabetic ketoacidosis among patients with diabetes mellitus receiving follow-up care in public health centers of Lideta Sub-City, Addis Ababa: a retrospective cohort study, 2023
- 1School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- 2School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
- 3School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
Abstract
Background: The most dangerous acute consequence of diabetes mellitus is diabetic ketoacidosis, which has become more prevalent in diabetic individuals. Although diabetic ketoacidosis is becoming more common in people with diabetes mellitus, little is known about its incidence and predictors. In Ethiopia, this is particularly true.
Objective: To assess the incidence of diabetic ketoacidosis and its predictors among patients with diabetes mellitus attending follow-up care in public health centers of Lideta Sub-City, Addis Ababa, Ethiopia.
Method: A retrospective follow-up study was conducted among diabetic mellitus patients who were registered from January 1, 2018, to December 31, 2022, in Lideta Sub-City public health centers, Addis Ababa, Ethiopia. Sampling with probability proportional to size and the simple random sampling technique were used to select patients. Data were collected from the patient charts by using a pretested checklist. The data were entered into EPI data version 3.1 and analyzed using STATA version 14.0. The Cox proportional hazard regression model was fitted to identify the independent predictors of diabetic ketoacidosis.
Results: Out of the 419 diabetic patients included in the study, 114 (27.2%) developed Diabetic Ketoacidosis in the entire follow-up period. Hence, the cumulative incidence was 0.742 per 100-person-month of observation. Type 1 diabetes mellitus (AHR = 1.88, 95%CI: 1.12, 3.15), history of medication noncompliance (AHR = 2.7, 95% CI: 1.52, 4.8), recent six month poor glycemic control (AHR = 1.9, 95% CI: 1.07, 3.4), acute recent illness (AHR = 1.75, 95% CI: 1.02, 3.01) and talking insulin medication (AHR = 2.32, 95% CI: 1.39, 3.8) were significant predictors of DKA.
Conclusion: The incidence of diabetic ketoacidosis was high. Uncontrolled recent six-month glycemic levels, taking insulin medication rather than OHGA, having type 1 diabetes mellitus, has a history of medication noncompliance, and acute illness were the predictors. Diabetic care should prioritize these predictors to mitigate the public health and economic impacts of diabetic ketoacidosis.
Clinical trial number: Not applicable.
Clinical trial registration: Not applicable.
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BibTeX
@article{kassaw2026incidence,
title = {{Incidence and predictors of diabetic ketoacidosis among patients with diabetes mellitus receiving follow-up care in public health centers of Lideta Sub-City, Addis Ababa: a retrospective cohort study, 2023}},
author = {Getasew Kassaw and Asressie Molla and Binalfew Tsehay and Mellese Tsehay},
journal = {BMC Endocrine Disorders},
year = {2026},
month = jul,
doi = {10.1186/s12902-026-02440-6},
url = {https://doi.org/10.1186/s12902-026-02440-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Incidence and predictors of diabetic ketoacidosis among patients with diabetes mellitus receiving follow-up care in public health centers of Lideta Sub-City, Addis Ababa: a retrospective cohort study, 2023
AU - Getasew Kassaw
AU - Asressie Molla
AU - Binalfew Tsehay
AU - Mellese Tsehay
PY - 2026
DA - 2026/07/28
JO - BMC Endocrine Disorders
DO - 10.1186/s12902-026-02440-6
UR - https://doi.org/10.1186/s12902-026-02440-6
AB - Background: The most dangerous acute consequence of diabetes mellitus is diabetic ketoacidosis, which has become more prevalent in diabetic individuals. Although diabetic ketoacidosis is becoming more common in people with diabetes mellitus, little is known about its incidence and predictors. In Ethiopia, this is particularly true. Objective: To assess the incidence of diabetic ketoacidosis and its predictors among patients with diabetes mellitus attending follow-up care in public health centers of Lideta Sub-City, Addis Ababa, Ethiopia. Method: A retrospective follow-up study was conducted among diabetic mellitus patients who were registered from January 1, 2018, to December 31, 2022, in Lideta Sub-City public health centers, Addis Ababa, Ethiopia. Sampling with probability proportional to size and the simple random sampling technique were used to select patients. Data were collected from the patient charts by using a pretested checklist. The data were entered into EPI data version 3.1 and analyzed using STATA version 14.0. The Cox proportional hazard regression model was fitted to identify the independent predictors of diabetic ketoacidosis. Results: Out of the 419 diabetic patients included in the study, 114 (27.2%) developed Diabetic Ketoacidosis in the entire follow-up period. Hence, the cumulative incidence was 0.742 per 100-person-month of observation. Type 1 diabetes mellitus (AHR = 1.88, 95%CI: 1.12, 3.15), history of medication noncompliance (AHR = 2.7, 95% CI: 1.52, 4.8), recent six month poor glycemic control (AHR = 1.9, 95% CI: 1.07, 3.4), acute recent illness (AHR = 1.75, 95% CI: 1.02, 3.01) and talking insulin medication (AHR = 2.32, 95% CI: 1.39, 3.8) were significant predictors of DKA. Conclusion: The incidence of diabetic ketoacidosis was high. Uncontrolled recent six-month glycemic levels, taking insulin medication rather than OHGA, having type 1 diabetes mellitus, has a history of medication noncompliance, and acute illness were the predictors. Diabetic care should prioritize these predictors to mitigate the public health and economic impacts of diabetic ketoacidosis. Clinical trial number: Not applicable. Clinical trial registration: Not applicable.
SN - 1472-6823
ER -