Abstract:
Background: Diabetic ketoacidosis (DKA) is a hyperglycemic emergency associated with high
morbidity and mortality in patients with diabetes. This is due to poor blood glucose monitoring,
lack of follow-up, and use of a substance. Even though the burden of diabetic ketoacidosis has
increased, limited studies conducted on the determinants of Diabetes ketoacidosis in Ethiopia.
Objective: The aim of this study was to identify the determinants of diabetic ketoacidosis among
adult diabetic patients attending their treatment at Ambo town public hospitals, Ambo, Ethiopia
2024.
Methods: Institution Based Unmatched Case-Control Study was conducted among adult diabetic
patients attended their treatment at Ambo town hospitals; among 80 cases (diabetic with
ketoacidosis) consecutively selected and 240 control (diabetic without ketoacidosis) selected
using systematic random sampling techniques. Data were collected using the Kobo Tool box
android application, structured, and interviewer-administered questionnaires and then exported to
SPSS version 27 for coding, to clean, avoid inconsistencies, incompleteness before analysis.
Binary logistic regression analysis was computed and variables with p-value < 0.25 were
considered a candidate for multivariable logistic regression. A finding was presented by using
texts, tables and graphs. Adjusted Odds Ratios (AOR) with 95% confidence intervals was
estimated to identify the association. Statistical significance was declared at a p-value <0.05.
Results: A total of 308 (78cases and 230 control) diabetic clients were included in the study,
with a response rate of 96.25%. This study identified having Type one diabetes mellitus [AOR:
3.5; 95% CI (1.54–7.96)], presence of comorbidity [AOR: 4.82; 95% CI (2.03–11.42)], Irregular
follow-up in the chronic care, [AOR: 6.14; 95% CI (2.25–14.7)], discontinuation of anti-diabetic
medication [AOR: 3.07; 95% CI (1.34– 7.04)], not using community based health insurance
[AOR: 5.00; 95% CI (2.22–11.26)], Diabetic Complications [AOR: 4.25; 95% CI (1.59–11.3)],
were significant determinants of diabetic ketoacidosis.
Conclusion: In this study, having type one DM, presence of comorbidity, Irregular follow-up in
the chronic care, discontinuation of anti-diabetic medications, not using community based health
insurance and diabetes complications were identified as significant determinants of diabetic
ketoacidosis. Because diabetic ketoacidosis is life-threatening event, effective methods and
interventions on determinants of diabetic ketoacidosis should be implemented.
