Determinants Of Diabetic Ketoacidosis Among Adult Diabetes Mellitus Patients At Ambo Town Public Hospitals Oromia Ethiopia

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.