Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a systematic review

Abstract

Aims: Diabetic ketoacidosis (DKA) is an acute and risky complication of type 1 diabetes. The aim of this study is to build the overall rate of DKA in Arab patients with type 1 diabetes in the 22 Arab nations. This is expected to tailor the healthcare approaches in Arab countries where attention is needed to save lives from the devastating consequences of DKA. Methods: The study here is a quantitative analysis of the articles indexed in four different scientific literature databases: Web of Science, PubMed, Science Direct and Scopus, from inception to June 2015. Arab patients with type 1 diabetes who presented with DKA have been captured. Key information was possible to extract for patients belong to only 12 Arab countries out of the 22 Arab patients. Results: Twenty-nine studies in 12 different Arab countries captured 4,688 type 1 diabetes patients with overall rates of 46.7% patients presented with DKA, ranging from a low of 17% in Egypt to a high of 100% in Morocco, Algeria and Tunisia. Conclusion: This is the first descriptive quantitative study to determine the overall DKA rate in 46 years of studies in the Arab world of patients with type 1 diabetes; DKA rates were found to range from 17% to 100% with overall rate of 46.7%. Review criteria• In 46 years of studies across Arabia, the overall rate of DKA is 46.7% in 12 Arab countries.• The higher the incidence and prevalence of type 1 diabetes, the higher rates of DKA in Arab countries.• Consanguinity and family history are common among Arab patients with type 1 diabetes who presented with DKA.

Incidence, prevalence and clinical manifestations at onset of juvenile diabetes in Tanzania

“…In this study there is no difference in female:male ratio, 1.1:1, observed in other African countries [14]. However Zanzibar, whose population partly has Arab ethnicity, had more female patients (62.3% female vs 37.7% male) which is in accordance to other Arab Countries [21] which differs from what is seen in several caucasian populations where T1D is slightly more common among boys <15 years of age and >15 years of age twice as common among males as among females. Of the children with documentation regarding family history of diabetes, 30.6% had first degree relatives which is 2-3 times more common than generally observed in western countries [1,2].…”

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“…age group. Different studies showed variable prevalence of DKA among different countries ranging from 17% (Egypt) to 67% (Saudi Arabia) 22 24 that may be attributed to marked β cell damage and late diagnosis. However this is in sharp contrast to the SW lone findings from Pakistan who reported that more than one half (55.5%) of the children with DKA were older than 10 yrs.…”

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“…The dissimilarity of PN among the different Arab countries possibly reflects the genetic and socioeconomic heterogeneity of the people in this Arab region. Further, differences in the methods of measuring the outcome between different studies could also associated with this heterogeneity [ 62 ].…”