Precipitating factors for diabetic ketoacidosis

OBJECTIVE: The aim of this study is to identify the precipitating factors from a medical and social point of view, in addition to discussing some clinical and laboratory aspects of diabetic ketoacidosis.

METHODS: Sixty-eight patients were admitted to King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, over a 2 year period, (April 1999 through to April 2001). Diagnosis of diabetic ketoacidosis was based on: clinical features, serum sugar >12 mmol\L with ketonuria, bicarbonate and base deficit.

RESULTS: The mean age was 22.5 years (0.5-87) years with a male to female ratio of 1.4:1. Poor compliance to continue the treatment and infection were the most common precipitating factors being responsible for 54.4% and 28% cases. A low mortality rate of 2.9% in our study compared favorably with other studies, which contributed to a high level of medical care in King Abdulaziz University Hospital.

CONCLUSION: Diabetic ketoacidosis is a fatal complication among our diabetic patients. Implementing a patient education program to increase awareness of the disease is the most important step in the prevention of this complication. The authorities should ensure availability of insulin to all patients, either free or at lower prices. The role of cultured and socioeconomic factors in aggravating or precipitating diabetic ketoacidosis should always be considered and where possible, eliminated.