Investigation of Recurrent Diabetic Ketoacidosis Pattern in Southeast Iran: Analysis of Prevalence, Risk Factors, and Clinical Outcomes in a Four-Year Study

Hossein  Rezazadeh; MohammadHossein  Gozashti; Behjat  Tajabadi

doi:10.18502/ijdl.v25i5.20340

Hossein Rezazadeh Endocrinology and Metabolism Research Center, Kerman University of Medical Sciences, Kerman, Iran
MohammadHossein Gozashti Endocrinology and Metabolism Research Center, Kerman University of Medical Sciences, Kerman, Iran
Behjat Tajabadi Endocrinology and Metabolism Research Center, Kerman University of Medical Sciences, Kerman, Iran

DOI: https://doi.org/10.18502/ijdl.v25i5.20340

Keywords: Recurrent Diabetic Ketoacidosis, Type 1 Diabetes, Risk Factors, Prevalence, Clinical Outcomes

Abstract

Background: Recurrent diabetic ketoacidosis is one of the serious and life-threatening complications of diabetes that can lead to repeated hospitalizations and significant complications. This study was conducted with the aim of investigating the prevalence, risk factors, and clinical outcomes of recurrent diabetic ketoacidosis in southeast Iran.

Methods: In this retrospective descriptive-cross-sectional study, the medical records of 560 patients with diabetic ketoacidosis during the years 2017-2020 at Afzalipour Hospital in Kerman were reviewed. Patients with at least two admissions due to diabetic ketoacidosis were included in the study. Demographic, clinical, and laboratory data were collected and analyzed using a checklist. The collected data were analyzed using SPSS software version 25 with chi- square and independent t-tests at a significance level of 0.05.

Results: Of 560 patients, 40 patients (7.16%) had recurrent diabetic ketoacidosis. The mean age of patients was 28.36 ± 15.04 years, and 60% were women. 70% of patients had type 1 diabetes. The most common underlying causes included irregular consumption or discontinuation of insulin (72.5%) and presence of infection (55%). Substance abuse was reported in 25% of patients. The mean serum levels of urea, creatinine, and potassium were 55.23 ± 37.73 mg/dL, 0.98 ± 0.67 mg/dL, and 4.38 ± 0.64 mEq/L, respectively.

Conclusion: This study showed that patients with type 1 diabetes are at higher risk of recurrent diabetic ketoacidosis. Non-adherence to insulin therapy and infections were the most important identified risk factors. These findings emphasize the importance of patient education regarding regular insulin consumption and prevention of infections.