What question did this study set out to answer?

This research evaluates the clinical profile and severity of diabetic ketoacidosis in adults.

March 9, 2026Open Access

Clinical profile of diabetic ketoacidosis and its severity in adults: evidence from ALERT Comprehensive Specialized Hospital

Key Result

Severe DKA was present in 55% of cases, with female gender doubling severity risk (AOR 2.1) and comorbidities reducing severity by 50% (AOR 0.50).

Key Points

This research evaluates the clinical profile and severity of diabetic ketoacidosis in adults.
Cross-sectional hospital-based study design.
Patients admitted to the emergency unit were included.
DKA severity assessment based on modified JBDS guidelines.
Data analyzed using SPSS version 27.
60.7% of DKA patients were male with a mean age of 38.9 years.
55% of participants experienced severe DKA based on JBDS criteria.
Infection was identified as the main precipitating factor in 33.4% of cases.
Female patients had a twofold higher odds of severe DKA; AOR: 2.1.
Comorbidity reduced DKA severity by 50%; AOR: 0.50.

Structured PICO

Population

422 adult patients (>16 years) with diabetes and Diabetic Ketoacidosis (DKA) admitted to the emergency unit of ALERT Comprehensive Specialized Hospital in Ethiopia. Mean age 38.9 years, 60.7% male. Excluded: pregnant/breastfeeding women, incomplete charts.

Outcome

Clinical characteristics, severity of DKA (based on modified JBDS criteria), and factors associated with DKA severity

Over half of adult DKA patients in this Ethiopian cohort presented with severe DKA, with female sex and lack of comorbidities associated with higher severity.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background Diabetic Ketoacidosis (DKA) is one of the most common acute complications of patients diagnosed with Diabetes mellitus. We aimed to assess clinical characteristics, severity of DKA and factors associated with DKA among adult patients admitted at the emergency unit of ALERT Comprehensive Specialized Hospital. Methods A cross-sectional hospital-based study was used. DKA severity was assessed using a modified version of Joint British Diabetes Societies (JBDS) 2023 guideline. SPSS version 27 was used for data analysis. Results Of 422 patients with DKA, 60.7% were male. The mean age of the participants was 38.9(± 16.6) year. About a third (35.8%) of DKA cases were known type 2 DM patients. Underlining infection (33.4%) was the principal DKA precipitating factor. Based on modified JBDS criteria, 55% of the study participants had severe DKA. Tachycardia (23%) was the most frequently observed DKA severity criteria, followed by pH < 7.0. The frequency of DKA events in the majority of patients was reported only once (87%). About 32.9% of study participants had a urine ketone level of + 2. The odds of severe DKA were two times higher among female patients; AOR: 2.1 1.40–3.19 while the presence of comorbidity reduces DKA severity by 50%; AOR: 0.50 0.34–0.75. Conclusion This study found that over half of the participants had severe DKA. Early identification and management of infections in patients with diabetes are crucial to prevent severe DKA. Female gender was found to be an associated factor for severity. Clinical trial number Not applicable.

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