What precipitates diabetic ketoacidosis among Sudanese patients?

Ahmed, Awad Mohamed; Elmardi, Ahmed Eltigani; Elhilo, Kaltoum Farok

doi:10.1002/pdi.1022

Cited by 4 publications

(8 citation statements)

References 2 publications

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“…MIC countries represent 40.15% of T1D, and DKA frequency of 41.67% mostly shared by Egypt , followed by Tunisia , Morocco , Sudan , Algeria , Libya and Syria (Table and Figure ). Collectively for all Arab countries, excluding 281 patients from Libya, Sudan and Saudi Arabia who were surveyed initially as DKA patients as a result of having T1D (Tables and ) , the descriptive quantitative overall rate of the DKA is 46.7% among Arab patients with T1D.…”

Section: Resultsmentioning

confidence: 99%

“…In both the HIC and MIC (Tables and ), the study size is 4969 patients with T1D, of which 2469 developed DKA (49.7%); these patients were captured in 29 different individual studies surveying different areas across 12 different Arab countries (4 HIC and 8 MIC) for a period of 46 years between 1969 and 2015. In the studies reported here, the prevalence rates of DKA were estimated as a percentage of the T1D patients who presented with DKA; however, few studies ( n = 4) started with screening the patients who already have DKA as a result of T1D as was reported in Libya , Saudi Arabia and Sudan to eliminate this bias; these four studies were excluded from calculating the overall percentage of DKA, and the final ratio now is 46.7%.…”

Section: Resultsmentioning

confidence: 99%

“…The percentage of T1D or DKA patients of each Arab country was obtained, after excluding the studies ( n = 4) that start with DKA patients as a consequence of T1D , by dividing the number of patients with either T1D or T1D with DKA in each country by the total number of patients of all Arab countries for either T1D or DKA patients, respectively. Both the T1D and DKA rates were plotted against the incidence rates and prevalence estimates for the HIC (Figure ) and MIC (Figure ).…”

Section: Discussionmentioning

confidence: 99%

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

Zayed

2016

Int J Clin Pract

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Zayed

2016

Int J Clin Pract

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“…McLarty et al (5) found that patients requiring insulin prehospitalisation had particularly worse hospital survival than those that did not require insulin, amongst the former 26% died of DKA. Ahmed et al (6) found that DKA was responsible for 54% of diabetic hospitalisations in a Sudanese hospital over a two year period. This Sudanese study did not specify important clinico-laboratory predictors of outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors in patients hospitalised with diabetic ketoacidosis at Kenyatta National Hospital, Nairobi

Otieno

Kayima²,

Mbugua³

et al. 2010

E Af Med Jrnl

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Background: In spite of many advances in the management of diabetes in the last 25 years, the mortality associated with diabetic ketoacidosis (DKA) remains high, especially in the developing countries. The mortality appears greatest in the first 24 -48 hours of their treatment. Most of the previous studies on DKA focused on children and the precipitating factors thereof but not particularly on clinical predictors of outcomes. Objective: To determine the clinico-laboratory predictors of outcomes of patients hospitalised with diabetic ketoacidosis who were undergoing treatment. Design: Cross-sectional descriptive study. Setting: The accident and emergency department and medical wards of the Kenyatta National Hospital. Subjects: Fifty one patients hospitalised with diabetic ketoacidosis over a nine month period were evaluated clinically and by laboratory tests. They were managed in the standard way with insulin, intravenous fluids and appropriate supportive care. Main outcome measures: Serial assays of serum electrolytes, glucose and blood pH, HbA1c and clinical outcome of either discharge home or death. Results: Of the 51 patients enrolled, 47 were included in the final analysis. Fourteen (29.8%) patients died, and the deaths occurred within less than 48 hours of hospitalisation and treatment. Of the patients who died, all (100%) had altered level of consciousness at hospitalisation, 71.4% had abnormal renal functions, 64.3% were newly diagnosed and an equal proportion of 64.3% were females. The alteration in the level of consciousness was significantly associated systolic hypotension and severe metabolic acidosis, (p<0.001). Patients with altered level of consciousness also had poorer renal function. Conclusion: Apparently DKA still carries high mortality during treatment in hospital. Altered level of consciousness, which is an obvious and easily discernible clinical sign, was a major predictor of mortality in our study patients. The majority of patients with altered level of consciousness also had systolic hypotension, severe metabolic acidosis and impaired renal function. Even where and when detailed laboratory evaluation is elusive, clinical signs, especially altered level of consciousness and systolic hypotension are very important markers of severity of DKA that may be associated with unfavourable outcomes. Further studies are necessary to establish why DKA still carries high mortality in the patients who are already receiving treatment in hospitals in developing countries.

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“…A review of these publications worldwide is beyond the scope of the present discussion. However, we note with interest those reports coming from the developing world in particular (22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 80%

Hospitalization patterns of diabetic patients to a tertiary hospital in Abu Dhabi, United Arab Emirates

Beshyah

Khalil

Benbarka

et al. 2011

Ibnosina Journal of Medicine and Biomedical Sciences

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Background: Hospitalization occurs more often in diabetic than non-diabetic patients and is associated with increased morbidity and mortality. Data on these issues are limited in the Middle East, particularly in new nations suffering from a high prevalence of diabetes. Objectives: We studied the contribution of diabetes to the hospital admission rates and evaluated the database-documented causes and outcomes of hospitalization of people with diabetes in a tertiary hospital. Methods and Patients: This was a descriptive, retrospective, electronic records-based study. We identified 14,032 episodes accounted for by diabetes (i.e. 19.1% of the total 51,169 episodes) between 2000-06. Results: 19.1% of admission episodes involved diabetes with an ascending linear trend. The median length of stay was five and four days for diabetes as a primary diagnosis and as a secondary diagnosis respectively. Diabetes as a primary diagnosis was noted in 1,227 patients. The mean age was 42.5 years, and majority were in the 50-70 years age group. Most patients were admitted from the emergency room (71%). Reason for admission was attributed to diabetes per se in >50%, and the majority were discharged home in good condition. On the other hand, diabetes was present as a secondary diagnosis in 8,540 patients (3,494 women and 2,794 Emirati nationals). The mean age of this subgroup was 58.4 years with majority being 41-80 years old. These patients were admitted either as a medical emergency (70%) or directly from home (27%). Patients were admitted under internal medicine (36%), cardiology (27%) and haematology (21%) services. The majority (91%) were discharged home in good condition. A total of 353 patients died while hospitalized (23 with diabetes as a primary diagnosis and 330 when it was a secondary diagnosis respectively. The age at death was 68.8 and 65.4 years in the two subgroups respectively. Conclusions: The present study demonstrated that diabetes is associated with a high number of inpatient episodes. These involved mainly middle-aged adults due to medical and cardiovascular complications of diabetes, and poses a

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What precipitates diabetic ketoacidosis among Sudanese patients?

Cited by 4 publications

References 2 publications

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

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

Prognostic factors in patients hospitalised with diabetic ketoacidosis at Kenyatta National Hospital, Nairobi

Hospitalization patterns of diabetic patients to a tertiary hospital in Abu Dhabi, United Arab Emirates

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