Demographic, Clinical, and Biochemical Characteristics of Patients Admitted With Diabetic Ketoacidosis (DKA): A Retrospective Descriptive Study

Abstract

BACKGROUND: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are serious acute complications of diabetes associated with substantial morbidity and mortality worldwide, particularly in low- and middle-income countries. DKA disproportionately affects younger individuals with type 1 diabetes and remains a major cause of diabetes-related hospital admissions and deaths in resource-limited settings like Iraq. OBJECTIVE: This study aimed to assess the clinical presentation, precipitating factors, and in-hospital outcomes of patients admitted with DKA to hospitals under the Al-Karkh Health Directorate in Baghdad, Iraq. METHODS: We conducted a retrospective review of 200 patients (aged ≥16 years) admitted with DKA between January and June 2025. Data collected included demographics, clinical features, laboratory findings, DKA triggers, management, and outcomes. Descriptive statistics were used to report findings in frequency and percentage format. RESULTS: The majority of patients were young adults (87.5% aged ≤30 years) with a slight male predominance (55%). Type 1 diabetes was the most common diagnosis (61.5%), while 31.5% were newly diagnosed at presentation. The leading triggers of DKA were insulin non-compliance (50.5%) and infection (35%). Most patients presented with gastrointestinal symptoms (81.5%), while 16% exhibited confusion and 2.5% were in septic shock. Electrolyte disturbances were common, with 43.5% of patients exhibiting abnormal potassium levels. Intensive care unit (ICU) admission was required in 10.5% of cases, and the in-hospital mortality rate was 3.5%. CONCLUSION: DKA remains a major health burden among young adults with type 1 diabetes in Baghdad. The most common precipitating factors were missed insulin doses and infections. Strengthening patient education, improving access to insulin, and promoting early symptom recognition are crucial strategies to reduce DKA-related complications and mortality.