Epidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu, Somalia.

Epidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu, Somalia. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Epidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu, Somalia. Mohamed Ismael Iman This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8038111/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Diabetic ketoacidosis (DKA) is a severe complication primarily affecting type 1 diabetes patients, though it can also occur in type 2 diabetes. In Somalia, decades of conflict have weakened the healthcare system, limiting access to regular diabetes care and education, which heightens the risk of DKA. This study explores the epidemiological and clinical characteristics of DKA in diabetic patients at hospitals in Mogadishu, Somalia, to identify patterns, risk factors, and outcomes. Methods A cross-sectional study was conducted at Aden Cade, Kalkal, and Martini hospitals involving 140 diabetic patients with DKA. Data were gathered through structured questionnaires and clinical records, and statistical analysis was done using SPSS to assess sociodemographic determinants, clinical presentations, and risk factors for DKA. Result The majority of patients were under 18 years old, with 75% having type 1 diabetes. Common symptoms included excessive thirst (92.9%), frequent urination (97.1%), and abdominal pain (95.7%). All patients received insulin therapy, and most were also treated with antibiotics. Half of the patients experienced recurrent DKA episodes after discharge, indicating a need for improved diabetes management and follow-up care Conclusion remains a significant public health issue in Mogadishu due to limited healthcare access, insufficient patient education, and poor insulin to treatment. Addressing these challenges through better healthcare infrastructure, patient education, and management protocols could reduce DKA occurrences in Somalia. Internal Medicine Diabetic ketoacidosis Type 1diabetes Mogadishu Risk factors Clinical characteristics Insulin therapy Diabetes management 1. INTRODUCTION Diabetes is a chronic metabolic disease marked by persistently high blood glucose levels, which, over time, can lead to severe damage to critical organs such as the heart, kidneys, eyes, blood vessels, and nerves (WHO, 2023). Among its types, type 2 diabetes is the most prevalent, particularly among adults. Its global prevalence has increased dramatically over the past three decades across countries of all income levels. Type 1 diabetes, previously referred to as juvenile diabetes, is a lifelong condition where the pancreas produces little or no insulin. Access to affordable treatment, including insulin, is vital for the survival of individuals living with diabetes (WHO, 2023). A serious and potentially life-threatening complication of diabetes is diabetic ketoacidosis (DKA). While it primarily affects individuals with type 1 diabetes, it can also occur in type 2 diabetes under stress conditions such as infections or missed insulin doses. DKA results from an absolute or relative insulin deficiency, leading to hyperglycemia, ketosis, and metabolic acidosis. It remains a significant cause of morbidity and mortality, particularly in resource-constrained regions. The global burden of diabetes is paralleled by a rising incidence of DKA, especially in developing countries where healthcare systems may not be adequately prepared to manage such acute complications. Globally, the prevalence of diabetes mellitus continues to rise at an alarming rate. The International Diabetes Federation (IDF) reported that in 2021, around 537 million adults aged 20–79 were living with diabetes. This number is expected to grow to 643 million by 2030 and 783 million by 2045 (IDF, 2021). Diabetes has become the ninth leading cause of death worldwide, with over 4.2 million deaths recorded in 2019. DKA cases have also risen accordingly, largely driven by poor glycemic control, delayed diagnosis, missed insulin doses, and lack of disease management awareness. In many healthcare systems, DKA contributes significantly to hospital admissions and healthcare costs. In Africa, urbanization, dietary transitions, and increasingly sedentary lifestyles have led to a rapid increase in diabetes cases and its complications. According to the IDF, approximately 24 million people in Africa had diabetes in 2021, with projections estimating this will double by 2045 (IDF, 2021). Urban populations are particularly affected, given the surge in obesity and physical inactivity. However, healthcare infrastructures across much of the continent struggle to keep pace with the growing diabetes burden. Limited access to insulin, inadequate diagnostic services, and lack of patient education continue to fuel high DKA rates. Consequently, mortality rates from DKA in Africa range from 20% to 25%, compared to 1% to 5% in high-income nations (Wolfsdorf et al., 2018). In Somalia, the burden of diabetes is significant, yet comprehensive data remain scarce. Years of civil conflict, underfunded healthcare systems, and political instability have led to fragile health services that are ill-equipped to handle chronic diseases. It is estimated that diabetes affects 4% to 5% of Somali adults, although underreporting is likely due to the absence of nationwide surveillance systems (Hersi et al., 2021). Urbanization and the adoption of Western dietary habits are further driving diabetes prevalence, particularly in cities like Mogadishu. Unfortunately, most patients are unaware of the symptoms and complications of diabetes, including DKA, until emergencies arise. The management of diabetes in Somalia is hampered by the unavailability of insulin, lack of medical equipment, and insufficient trained professionals. Financial constraints and limited education among patients often lead to poor treatment adherence. A study by Mohamed et al. (2020) revealed a high incidence of DKA in hospitals in Mogadishu, with many patients being newly diagnosed diabetics. Late presentation and severe dehydration were common, worsening patient outcomes. The findings emphasized the critical need for early diagnosis, improved access to insulin, and increased community awareness. DKA is now recognized as a major public health concern in Somalia. Many patients reach hospitals in critical condition due to delays in seeking care, often staying at home for extended periods. Dehydration, infection, stress, and missed medications are frequent triggers of DKA. Emergency departments face additional challenges, such as lack of preparedness, insufficient staff training, and poor availability of intravenous fluids and laboratory services. Moreover, there is a notable lack of data regarding the prevalence and risk factors associated with DKA in key hospitals in Mogadishu, including Aden Abdulle Hospital, Kalkal Hospital, and Demartino Hospital. This information gap hinders the development of tailored interventions and effective emergency response strategies. Understanding the prevalence and associated risk factors of DKA is essential for improving resource allocation, emergency preparedness, and patient outcomes in Somalia’s fragile healthcare landscape. 2. METHODS 2.1 Study Design the Study Research Design Was a Hospital Based Analytical Cross-Sectional Study, Which Involved to Use of Quantitative About the Epidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu Somalia 2.2 Target Population of the Study The study population diabetic ketoacidosis in diabetic patients attending at Abu Bashir hospital, Kalkal hospital, and martini hospital. 2.3 Geographical area the study was conducted at patients attending at Abu Bashir Hospital, Kalkal hospital, and martini hospital. 2.5 Data collection instruments Data was collected using a structured questionnaire through KOBO Toolbox. The questionnaire consisted of close-ended questions designed to capture all required data. In addition to socio-demographic information, it included questions on general information about diabetic ketoacidosis and other associated conditions. 2.5 Data Analysis the analysis was conducted using SPSS Version 27. Descriptive statistics, including frequency, percentage, and cross-tabulation, were performed to summarize the data. Inferential analysis was carried out using univariate, bivariate, and multivariate analyses. Chi-square tests were applied to examine associations between variables, and odds ratios with 95% confidence intervals (CI). 3. RESULTS Table 1 Univariate analysis Socio-demographic characteristics of study respondents Table 1 shows the socio-demographic characteristics of the study participants. More than (37.1%) aged under 18 years. Most of the respondents (55.0%) were males, Majority of the participants, (50.7%) were married. A larger proportion of the respondents (41.4%) had no formal education. The majority of the respondents were unemployed (47.1%) while household income (> $ 100- $ 299) was 50.7%. The respondents (75.0%) were type 1 diabetic mellites, (45.0%) of them were diagnosed less than one year, and respondents (70.7%) were getting primary sources of healthcare in public hospitals. The majority 46.6% had no family history of diabetes, while 42.1%'s level of health literacy regarding diabetes is moderate. The respondents (43.6%) were weekly checking blood glucose levels with 75.7% having no chronic disease. majority of the respondents were living in urban areas (92.0%) Table 1 Univariate analysis sociodemographic determinants of dka among diabetic patients Variables N % What is your age group? Under 18 years 52 37.1% 18–29 years 39 27.9% 30–39 years 13 9.3% 40–49 years 6 4.3% 59–59 years 12 8.6% 60 and above years 18 12.9% Total 140 100% What is your gender? Male 77 55.0% Female 63 45.0% Total 140 100% What is your Marital Status Single 52 37.1% Married 71 50.7% Divorced 8 5.7% Windowed 9 6.4% Total 140 100% What is your highest Level of Education? No formal education 58 41.4% Primary education 24 17.1% Secondary education 46 32.9% Tertiary education 12 8.6% Total 140 100% What is your employment status? Employed 21 15.0% Self Employed 38 27.1% Unemployed 66 47.1% Retired 15 10.1% Total 140 100% what is your monthly household income Less than $ 100 29 20.7% > $ 100- $ 299 71 50.7% > $ 300- $ 499 36 25.7% $ 500 and above 4 2.9% Total 140 100% What type of diabetes do you have Type 1 diabetes 105 75.0% Type 2 diabetes 35 25.0% Total 140 100% Table 2 : - Univariate analysis clinical presentations and management outcomes of diabetic ketoacidosis (DKA) among 140 diabetic patients. In terms of hospitalization frequency for DKA in the past year, 10.7% of patients reported no hospitalizations, 72.1% were hospitalized once, 16.1% were hospitalized 2–3 times, and 0.7% were hospitalized more than three times.Regarding symptoms prior to the DKA episode, 92.9% experienced excessive thirst, and 7.1% did not. Additionally, 97.1% of patients experienced frequent urination, while 2.9% did not. Abdominal pain was reported by 95.7% of patients before the DKA episode, and 4.3% did not experience it.At the time of hospital admission, 67.9% of patients were conscious, while 32.1% were not. Regarding the time taken to seek medical care, 57.9% sought care within 6 hours of symptom onset, 29.3% within 12 hours, 10.0% within 24 hours, and 2.9% sought care after 24 hours.During treatment, all 140 patients (100%) received insulin therapy. Fluid therapy was administered to 99.3% of patients, while 0.7% did not receive it. Antibiotics were administered to 93.3% of patients, and 5.7% did not receive antibiotics. In terms of care settings, 80.7% of patients were monitored in the intensive care unit, while 19.3% were not. For hospital stays during DKA treatment, 6.4% stayed less than 24 hours, 82.9% stayed 1–3 days, 7.9% stayed 5–7 days, and 2.9% stayed more than 7 days.Complications during or after treatment were reported by 45.0% of patients, while 55.0% did not experience any complications. Regarding recurrent DKA episodes after discharge, 50.0% of patients experienced recurrence, while the other 50.0% did not. Concerning hospital stays, 77.9% stayed less than 3 days, 19.3% stayed 3–7 days, and 2.9% stayed more than 7 days.When asked about confidence in managing diabetes after the DKA episode, 30.7% of patients were very confident, 57.1% were somewhat confident, and 12.1% were not confident. Following the prescribed management plan after the DKA episode was reported by 84.3% of patients, while 15.7% did not follow the plan. For regular follow-up appointments, 80.7% of patients attended them, while 19.3% did not. As for the frequency of experiencing hyperglycemia symptoms after DKA treatment, 4.3% reported never experiencing symptoms, 9.3% rarely experienced them, 75.0% sometimes experienced them, and 11.4% experienced them often. Table 2 Univariate analysis clinical presentations and management outcomes of DKA among diabetic patients Variable N % How many times have you been hospitalized for DKA in the past year None 15 10.7% 1 time 101 72.1% 2–3 times 23 16.1% More than 3 times 1 0.7% Total 140 100% Did you experience excessive thirst prior to the DKA episode? Yes 130 92.9% No 10 7.1% Total 140 100% Did you experience frequent urination prior to the DKA episode? Yes 136 97.1% No 4 2.9% Total 140 100% Did you have abdominal pain before the DKA episode? Yes 134 95.7% No 6 4.3% Total 140 100% Were you conscious upon hospital admission for DKA? Yes 95 67.9% No 45 32.1% Total 140 100% How soon after symptom onset did you seek medical care for DKA? Within 6 hours 81 57.9% Within 12 hours 41 29.3% Within 24 hours 14 10.0% After 24 hours 4 2.9% Total 140 100% Did you receive insulin therapy during your DKA treatment? Yes 140 100% No 0 0% Total 140 100.0% Was fluid therapy administered? Yes 139 100% No 1 94.3% Total 140 100% Were antibiotics administered? Yes 132 93.3% No 8 5.7% Total 140 100% Were you monitored in the intensive care units Yes 113 80.7% No 27 19.3% Total 140 100% How long was your hospital stay during your DKA treatment? Less than 24 hours 9 6.4% 1–3 days 116 82.9% 5–7 days 11 7.9% More than 7 days 4 2.9% Total 140 100% Did you experience any complications during or after your DKA treatment? Yes 63 45.0% No 77 55.0% Total 140 100% How long was your hospital stay for the DKA episode? Less than 3 days 109 ,77.9% 3–7 days 27 19.3% More than 7days 4 2.9% Total 140 100% Have you had a recurrent episode of DKA after discharge? Yes 70 50.0 No 70 50.0% Total 140 100% How confident are you in managing your diabetes after your DKA episode? Very confident 43 30.7% Somewhat confident 80 57.1% Not confident 17 12.1% Total 140 100% Have you been able to follow the management plan prescribed to you after your DKA episode? Yes 118 84.3% No 22 15.7% Total 140 100% Do you regularly attend follow-up appointments for your diabetes management? Yes 113 80.7% No 27 19.3% Total 140 100% How often do you experience symptoms of high blood glucose (hyperglycemia) after your DKA treatment? Never 6 4.3% Rarely 13 9.3% Sometimes 105 75.0% Often 16 11.4% Total 140 100% Table 3 : bivariate analysis Correlation Between Gender and Primary Source of Healthcare Table 3 bivariate analysis correlation between gender and primary source of healthcare Variables What is your primary source of healthcare? P value Public hospital Private hospital Gender categories N (%) N (%) 0.588 Male 53(37.86%) 24(17.14%) Female 46(32.86%) 17(12.14%) This table assesses the primary source of healthcare (public or private hospitals) by gender. A higher proportion of males (37.86%) relied on public hospitals, while 32.86% of females did the same. Both males (17.14%) and females (12.14%) had low utilization of private hospitals. Table 4 : bivariate analysis Correlation Between Type of Diabetes and Recurrent DKA Episodes Table 4 bivariate analysis correlation between type of diabetes and recurrent episode of dka after discharge variables Have you had a recurrent episode of DKA after discharge? P value No Yes Type of diabetes Categories N (%) N (%) 0.011 Type 1 Diabetes 46(32.85%) 59(42.14%) Type 2 Diabetes 24(17.14%) 11(7.85%) The table correlates diabetes type with recurrent DKA episodes after discharge. Those with Type 1 Diabetes had the highest recurrence of DKA (42.14%) and also Low Percentage Only 7.85% of individuals with Type 2 Diabetes experienced recurrent DKA. The P-value of (0.011) suggests a statistically significant. Table 5 : bivariate analysis Correlation between excessive thirst prior to the DKA episode and regularly monitor blood glucose levels at home The Table 5 examines the correlation between experiencing excessive thirst prior to a diabetic ketoacidosis (DKA) episode and regularly monitoring blood glucose levels at home, with a p-value of 0.778 indicating no statistically significant association between the two variables. Among patients who experienced excessive thirst before the DKA episode, 42.1% did not regularly monitor their blood glucose levels at home, while 50.7% did. For those who did not experience excessive thirst prior to the episode, 3.7% did not regularly monitor their blood glucose, and 3.57% did.The p-value suggests that there is no significant correlation between having excessive thirst before a DKA episode and the practice of regularly monitoring blood glucose levels at home. Table 5 bivariate analysis correlation between excessive thirst prior to the dka episode and regularly monitor blood glucose levels at home Do you regularly monitor your blood glucose levels at home? P value No Yes excessive thirst prior to the DKA episode Categories N (%) N (%) 0.778 Yes 59(42.1%) 71(50.7%) No 5(3.7%) 5(3.57%) Table 6 : bivariate analysis Correlation Between Insulin Therapy and Recurrent DKA Episodes The table presents the correlation between receiving insulin therapy during diabetic ketoacidosis (DKA) treatment and having a recurrent episode of DKA after discharge, with a p-value of 0.0 indicating a statistically significant association. Among patients who received insulin therapy during their DKA treatment, 50% experienced a recurrent episode of DKA after discharge, and 50% did not. The p-value of 0.0 suggests a significant correlation between receiving insulin therapy and the likelihood of experiencing recurrent DKA episodes, although further details would be necessary to understand the nature and direction of this relationship. Table 6 bivariate analysis correlation between insulin therapy during dka treatment and recurrent episode of dka after discharge Have you had a recurrent episode of DKA after discharge? P value No Yes insulin therapy during your DKA treatment Categories N (%) N (%) 0.0 Yes 70(50%) 70(50%) Table 7 : bivariate analysis Correlation between excessive thirst prior to the DKA episode and regularly monitor blood glucose levels at home. The table explores the correlation between having other chronic illnesses and experiencing a recurrent episode of diabetic ketoacidosis (DKA) after discharge, with a p-value of 0.011 indicating a statistically significant association. Among patients with chronic illnesses, 0% with renal diseases experienced recurrent DKA, while 0.71% did. For those with hypertension, 10% did not experience recurrent DKA, and 5% did. Among patients with chronic respiratory diseases, 2.1% did not experience recurrent DKA, and 0.71% did. Those with chronic liver diseases had 2.8% without recurrent DKA and none with recurrent episodes. Similarly, 2.8% of patients with cardiovascular diseases did not experience recurrent DKA, and none did. For patients without any chronic illnesses, 32.1% did not experience recurrent DKA, while 43.5% did. The significant p-value suggests that the presence of other chronic illnesses is associated with the likelihood of having a recurrent episode of DKA after discharge. Table 7 bivariate analysis correlation between other chronic illnesses and recurrent dka Variables Have you had a recurrent episode of DKA after discharge? P value No Yes Other chronic illnesses Categories N (%) N (%) 0.011 Yes, renal diseases 0(0.0%) 1(0.71%) Yes, hypertension 14(10%) 7(5%) Yes, chronic respiratory disease 3(2.1%) 1(0.71%) Yes, chronic liver diseases 4(2.8%) 0(0.0%) Yes, cardiovascular diseases 4(2.8%) 0(0.0%) No 45(32.1%) 61(43.5%) Table 8 : Multivariate analysis of missing insulin doses and the socio-demographic characteristics The multivariate analysis explores the relationship between missing insulin doses and various socio-demographic characteristics. The results are summarized as follows: For age group, the p-value is 0.354, with an adjusted odds ratio (AOR) of 0.906 and a 95% confidence interval (CI) ranging from 0.735 to 1.117. This indicates that age group is not significantly associated with missing insulin doses.Gender has a p-value of 0.673, with an [AOR of 1.178 and a 95% CI of 0.550 to 2.522]. This suggests no significant association between gender and the likelihood of missing insulin doses.Marital status shows a p-value of 0.410, with an [AOR of 1.258 and a 95% CI ranging from 0.728 to 2.173], indicating no significant relationship between marital status and missing insulin doses. The highest level of education has a p-value of 0.001, with an [AOR of 0.511 and a 95% CI of 0.341 to 0.768]. This suggests that individuals with higher levels of education are significantly less likely to miss insulin doses.Employment status has a p-value of 0.143, with an [AOR of 0.756 and a 95% CI ranging from 0.519 to 1.099]. This indicates no significant association between employment status and missing insulin doses.Monthly household income has a p-value of 0.729, with an [AOR of 1.067 and a 95% CI ranging from. Table 8 multivariate analysis of missing insulin doses and the socio-demographic characteristics Variables P-value AOR 95% Confidence Interval Lower upper age group .354 .906 .735 1.117 gender .673 1.178 .550 2.522 marital status .410 1.258 .728 2.173 highest level of education .001 .511 .341 .768 employment status .143 .756 .519 1.099 monthly household income .729 1.067 .739 1.542 4. DISCUSSION The study reveals that diabetic ketoacidosis (DKA) is predominantly affecting younger individuals, with 37.1%) of patients aged under 18 years having developed DKA. About 65,000 children under 15 years develop type 1 diabetes each year, with up to 80% presenting with DKA. A significant number of patients have no formal education, which may impact their ability to understand and manage diabetes. DKA is more prevalent among people with type 1 diabetes and can also develop in people with type 2 diabetes. The majority of patients have been hospitalized for DKA at least once in the past year, with 92.9% reporting excessive thirst and 97.1% experiencing frequent urination. Abdominal pain is another common symptom, with abdominal pain being the most common. Insulin therapy and antibiotics are the standard of care, with intravenous insulin by continuous infusion being the standard of care.Physical exercise is practiced daily by 57.9% of patients, and 80.7% are non-smokers. Recent infections are reported by 72.1%, while 73.6% have no other chronic illnesses. Stress or emotional distress is experienced by 62.1%, and 58.6% have not received education on managing sick days. The study also found a significant correlation between education level and health literacy regarding diabetes management. Patients with higher education levels were more likely to have a better understanding of diabetes management, while those with poor understanding of DKA symptoms had the lowest confidence. 5. CONCLUSION As highlighted in our study, focused on the sociodemographic determinants, clinical presentations, management outcomes, and risk factors and predictors. To tackle these factors, the findings of this study underscore the importance of socio-demographic factors, education, and lifestyle choices in the management and outcomes of diabetes and DKA. The significant associations between education, employment, and health literacy suggest that targeted interventions to improve education and employment opportunities may positively impact diabetes management. Additionally, the role of physical activity and psychological well-being in reducing hospital stays and preventing recurrent DKA episodes should be prioritized in future interventions. These results highlight the need for a comprehensive approach to diabetes care that considers socio-economic, psychological, and lifestyle factors. 6. RECOMMENDATION The text emphasizes the importance of enhancing diabetes education, promoting regular insulin use, improving access to diabetes medications, promoting a diabetes-specific diet, strengthening physical activity, addressing psychological stress, enhancing monitoring in healthcare settings, improving understanding of DKA symptoms, addressing socio-demographic disparities, integrating chronic illness management with diabetes care, monitoring and adjusting interventions based on patient feedback, increasing support for newly diagnosed patients, promoting regular healthcare visits, fostering community engagement, and evaluating and improving healthcare systems. These strategies aim to improve patient outcomes, reduce barriers to care, improve patient-provider communication, and ensure responsiveness to the needs of diabetic patients. By addressing these aspects, the healthcare system can better address the needs of diabetic patients and promote overall health. 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The Cochrane Database of Systematic Reviews , 2 , CD000567. https://doi.org/10.1002/14651858.CD000567.pub6 Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8038111","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":540383380,"identity":"179e751d-e1fd-465c-bc9f-247117f85022","order_by":0,"name":"Mohamed Ismael Iman","email":"data:image/png;base64,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","orcid":"https://orcid.org/0009-0007-7979-1640","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Mohamed","middleName":"Ismael","lastName":"Iman","suffix":""}],"badges":[],"createdAt":"2025-11-05 11:57:31","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8038111/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8038111/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95314071,"identity":"a04b0f45-4461-45d3-9a89-be7e8bbc4a4b","added_by":"auto","created_at":"2025-11-06 15:52:27","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":40406,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-8038111/v1/cab0f87b0f9a29a3dd0c0a0c.docx"},{"id":95281100,"identity":"bac12f5d-12d5-4145-96d4-09db9674ed87","added_by":"auto","created_at":"2025-11-06 09:12:00","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs8038111.json","url":"https://assets-eu.researchsquare.com/files/rs-8038111/v1/6cb0ca6c30e18fbd4f011a38.json"},{"id":95281104,"identity":"53b82f5a-4d17-4cee-8cf0-076b48a8c37d","added_by":"auto","created_at":"2025-11-06 09:12:01","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":107018,"visible":true,"origin":"","legend":"","description":"","filename":"rs80381110enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8038111/v1/e4407adedd18d03b0469e878.xml"},{"id":95281102,"identity":"06159eb2-19cc-4f09-a95b-6362b8add48a","added_by":"auto","created_at":"2025-11-06 09:12:01","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":103319,"visible":true,"origin":"","legend":"","description":"","filename":"rs80381110structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8038111/v1/0c303a5f5ac676c66cf85b7f.xml"},{"id":95281103,"identity":"aa4d37c8-53e9-4722-b44b-18ff86f670c9","added_by":"auto","created_at":"2025-11-06 09:12:01","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":111097,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8038111/v1/46e3650c75a389f429fd56ee.html"},{"id":95315747,"identity":"a9040caf-cf01-446e-891b-e124e1f5447e","added_by":"auto","created_at":"2025-11-06 15:56:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1536972,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8038111/v1/b365038f-83ad-4eb8-b600-892290a498fd.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eEpidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu, Somalia.\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eDiabetes is a chronic metabolic disease marked by persistently high blood glucose levels, which, over time, can lead to severe damage to critical organs such as the heart, kidneys, eyes, blood vessels, and nerves (WHO, 2023). Among its types, type 2 diabetes is the most prevalent, particularly among adults. Its global prevalence has increased dramatically over the past three decades across countries of all income levels. Type 1 diabetes, previously referred to as juvenile diabetes, is a lifelong condition where the pancreas produces little or no insulin. Access to affordable treatment, including insulin, is vital for the survival of individuals living with diabetes (WHO, 2023). A serious and potentially life-threatening complication of diabetes is diabetic ketoacidosis (DKA). While it primarily affects individuals with type 1 diabetes, it can also occur in type 2 diabetes under stress conditions such as infections or missed insulin doses. DKA results from an absolute or relative insulin deficiency, leading to hyperglycemia, ketosis, and metabolic acidosis. It remains a significant cause of morbidity and mortality, particularly in resource-constrained regions. The global burden of diabetes is paralleled by a rising incidence of DKA, especially in developing countries where healthcare systems may not be adequately prepared to manage such acute complications. Globally, the prevalence of diabetes mellitus continues to rise at an alarming rate. The International Diabetes Federation (IDF) reported that in 2021, around 537\u0026nbsp;million adults aged 20\u0026ndash;79 were living with diabetes. This number is expected to grow to 643\u0026nbsp;million by 2030 and 783\u0026nbsp;million by 2045 (IDF, 2021). Diabetes has become the ninth leading cause of death worldwide, with over 4.2\u0026nbsp;million deaths recorded in 2019. DKA cases have also risen accordingly, largely driven by poor glycemic control, delayed diagnosis, missed insulin doses, and lack of disease management awareness. In many healthcare systems, DKA contributes significantly to hospital admissions and healthcare costs. In Africa, urbanization, dietary transitions, and increasingly sedentary lifestyles have led to a rapid increase in diabetes cases and its complications. According to the IDF, approximately 24\u0026nbsp;million people in Africa had diabetes in 2021, with projections estimating this will double by 2045 (IDF, 2021). Urban populations are particularly affected, given the surge in obesity and physical inactivity. However, healthcare infrastructures across much of the continent struggle to keep pace with the growing diabetes burden. Limited access to insulin, inadequate diagnostic services, and lack of patient education continue to fuel high DKA rates. Consequently, mortality rates from DKA in Africa range from 20% to 25%, compared to 1% to 5% in high-income nations (Wolfsdorf et al., 2018). In Somalia, the burden of diabetes is significant, yet comprehensive data remain scarce. Years of civil conflict, underfunded healthcare systems, and political instability have led to fragile health services that are ill-equipped to handle chronic diseases. It is estimated that diabetes affects 4% to 5% of Somali adults, although underreporting is likely due to the absence of nationwide surveillance systems (Hersi et al., 2021). Urbanization and the adoption of Western dietary habits are further driving diabetes prevalence, particularly in cities like Mogadishu. Unfortunately, most patients are unaware of the symptoms and complications of diabetes, including DKA, until emergencies arise. The management of diabetes in Somalia is hampered by the unavailability of insulin, lack of medical equipment, and insufficient trained professionals. Financial constraints and limited education among patients often lead to poor treatment adherence. A study by Mohamed et al. (2020) revealed a high incidence of DKA in hospitals in Mogadishu, with many patients being newly diagnosed diabetics. Late presentation and severe dehydration were common, worsening patient outcomes. The findings emphasized the critical need for early diagnosis, improved access to insulin, and increased community awareness. DKA is now recognized as a major public health concern in Somalia. Many patients reach hospitals in critical condition due to delays in seeking care, often staying at home for extended periods. Dehydration, infection, stress, and missed medications are frequent triggers of DKA. Emergency departments face additional challenges, such as lack of preparedness, insufficient staff training, and poor availability of intravenous fluids and laboratory services. Moreover, there is a notable lack of data regarding the prevalence and risk factors associated with DKA in key hospitals in Mogadishu, including Aden Abdulle Hospital, Kalkal Hospital, and Demartino Hospital. This information gap hinders the development of tailored interventions and effective emergency response strategies. Understanding the prevalence and associated risk factors of DKA is essential for improving resource allocation, emergency preparedness, and patient outcomes in Somalia\u0026rsquo;s fragile healthcare landscape.\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study Design\u003c/strong\u003e the Study Research Design Was a Hospital Based Analytical Cross-Sectional Study, Which Involved to Use of Quantitative About the Epidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu Somalia\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Target Population of the Study\u003c/strong\u003e The study population diabetic ketoacidosis in diabetic patients attending at Abu Bashir hospital, Kalkal hospital, and martini hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Geographical area\u003c/strong\u003e the study was conducted at patients attending at Abu Bashir Hospital, Kalkal hospital, and martini hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Data collection instruments\u003c/strong\u003e Data was collected using a structured questionnaire through KOBO Toolbox. The questionnaire consisted of close-ended questions designed to capture all required data. In addition to socio-demographic information, it included questions on general information about diabetic ketoacidosis and other associated conditions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Data Analysis\u003c/strong\u003e the analysis was conducted using SPSS Version 27. Descriptive statistics, including frequency, percentage, and cross-tabulation, were performed to summarize the data. Inferential analysis was carried out using univariate, bivariate, and multivariate analyses. Chi-square tests were applied to examine associations between variables, and odds ratios with 95% confidence intervals (CI).\u003c/p\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e \u003cb\u003eUnivariate analysis Socio-demographic characteristics of study respondents\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the socio-demographic characteristics of the study participants. More than (37.1%) aged under 18 years. Most of the respondents (55.0%) were males, Majority of the participants, (50.7%) were married. A larger proportion of the respondents (41.4%) had no formal education. The majority of the respondents were unemployed (47.1%) while household income (\u0026gt;\u003cspan\u003e$\u003c/span\u003e100-\u003cspan\u003e$\u003c/span\u003e299) was 50.7%. The respondents (75.0%) were type 1 diabetic mellites, (45.0%) of them were diagnosed less than one year, and respondents (70.7%) were getting primary sources of healthcare in public hospitals. The majority 46.6% had no family history of diabetes, while 42.1%'s level of health literacy regarding diabetes is moderate. The respondents (43.6%) were weekly checking blood glucose levels with 75.7% having no chronic disease. majority of the respondents were living in urban areas (92.0%)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eUnivariate analysis sociodemographic determinants of dka among diabetic patients\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e\u003cp\u003eWhat is your age group?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnder 18 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e37.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u0026ndash;29 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u0026ndash;39 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u0026ndash;49 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59\u0026ndash;59 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60 and above years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWhat is your gender?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e55.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eWhat is your Marital Status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e37.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWindowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eWhat is your highest Level of Education?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo formal education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e41.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSecondary education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTertiary education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003eWhat is your employment status?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSelf Employed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e47.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRetired\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003ewhat is your monthly household income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLess than \u003cspan\u003e$\u003c/span\u003e100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u003cspan\u003e$\u003c/span\u003e100-\u003cspan\u003e$\u003c/span\u003e299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u003cspan\u003e$\u003c/span\u003e300-\u003cspan\u003e$\u003c/span\u003e499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan\u003e$\u003c/span\u003e500 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eWhat type of diabetes do you have\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eType 1 diabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eType 2 diabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e:\u003cb\u003e- Univariate analysis clinical presentations and management outcomes of diabetic ketoacidosis (DKA) among 140 diabetic patients.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn terms of hospitalization frequency for DKA in the past year, 10.7% of patients reported no hospitalizations, 72.1% were hospitalized once, 16.1% were hospitalized 2\u0026ndash;3 times, and 0.7% were hospitalized more than three times.Regarding symptoms prior to the DKA episode, 92.9% experienced excessive thirst, and 7.1% did not. Additionally, 97.1% of patients experienced frequent urination, while 2.9% did not. Abdominal pain was reported by 95.7% of patients before the DKA episode, and 4.3% did not experience it.At the time of hospital admission, 67.9% of patients were conscious, while 32.1% were not. Regarding the time taken to seek medical care, 57.9% sought care within 6 hours of symptom onset, 29.3% within 12 hours, 10.0% within 24 hours, and 2.9% sought care after 24 hours.During treatment, all 140 patients (100%) received insulin therapy. Fluid therapy was administered to 99.3% of patients, while 0.7% did not receive it. Antibiotics were administered to 93.3% of patients, and 5.7% did not receive antibiotics.\u003c/p\u003e\u003cp\u003eIn terms of care settings, 80.7% of patients were monitored in the intensive care unit, while 19.3% were not. For hospital stays during DKA treatment, 6.4% stayed less than 24 hours, 82.9% stayed 1\u0026ndash;3 days, 7.9% stayed 5\u0026ndash;7 days, and 2.9% stayed more than 7 days.Complications during or after treatment were reported by 45.0% of patients, while 55.0% did not experience any complications.\u003c/p\u003e\u003cp\u003eRegarding recurrent DKA episodes after discharge, 50.0% of patients experienced recurrence, while the other 50.0% did not. Concerning hospital stays, 77.9% stayed less than 3 days, 19.3% stayed 3\u0026ndash;7 days, and 2.9% stayed more than 7 days.When asked about confidence in managing diabetes after the DKA episode, 30.7% of patients were very confident, 57.1% were somewhat confident, and 12.1% were not confident. Following the prescribed management plan after the DKA episode was reported by 84.3% of patients, while 15.7% did not follow the plan.\u003c/p\u003e\u003cp\u003eFor regular follow-up appointments, 80.7% of patients attended them, while 19.3% did not. As for the frequency of experiencing hyperglycemia symptoms after DKA treatment, 4.3% reported never experiencing symptoms, 9.3% rarely experienced them, 75.0% sometimes experienced them, and 11.4% experienced them often.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eUnivariate analysis clinical presentations and management outcomes of DKA among diabetic patients\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eHow many times have you been hospitalized for DKA in the past year\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1 time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e72.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;3 times\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMore than 3 times\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDid you experience excessive thirst prior to the DKA episode?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e92.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDid you experience frequent urination prior to the DKA episode?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e136\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e97.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDid you have abdominal pain before the DKA episode?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eWere you conscious upon hospital admission for DKA?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e67.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eHow soon after symptom onset did you seek medical care for DKA?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWithin 6 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWithin 12 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWithin 24 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAfter 24 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDid you receive insulin therapy during your DKA treatment?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eWas fluid therapy administered?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e94.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eWere antibiotics administered?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e132\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e93.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eWere you monitored in the intensive care units\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eHow long was your hospital stay during your DKA treatment?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLess than 24 hours\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;3 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e82.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5\u0026ndash;7 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMore than 7 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDid you experience any complications during or after your DKA treatment?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e55.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eHow long was your hospital stay for the DKA episode?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLess than 3 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e,77.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u0026ndash;7 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMore than 7days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2.9%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eHave you had a recurrent episode of DKA after discharge?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e50.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eHow confident are you in managing your diabetes after your DKA episode?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVery confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSomewhat confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e57.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot confident\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eHave you been able to follow the management plan prescribed to you after your DKA episode?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e84.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eDo you regularly attend follow-up appointments for your diabetes management?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eHow often do you experience symptoms of high blood glucose (hyperglycemia) after your DKA treatment?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNever\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRarely\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSometimes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOften\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e140\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e:\u003cspan type=\"BoldItalicSmallCaps\" class=\"BoldItalicSmallCaps\" name=\"Emphasis\"\u003ebivariate analysis Correlation Between Gender and Primary Source of Healthcare\u003c/span\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ebivariate analysis correlation between gender and primary source of healthcare\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eWhat is your primary source of healthcare?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePublic hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrivate hospital\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003ecategories\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.588\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53(37.86%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24(17.14%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46(32.86%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(12.14%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThis table assesses the primary source of healthcare (public or private hospitals) by gender. A higher proportion of males (37.86%) relied on public hospitals, while 32.86% of females did the same. Both males (17.14%) and females (12.14%) had low utilization of private hospitals.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e:\u003cb\u003ebivariate analysis\u003c/b\u003e \u003cb\u003eCorrelation Between Type of Diabetes and Recurrent DKA Episodes\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ebivariate analysis correlation between type of diabetes and recurrent episode of dka after discharge\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003evariables\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eHave you had a recurrent episode of DKA after discharge?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eType of diabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategories\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eType 1 Diabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e46(32.85%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e59(42.14%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eType 2 Diabetes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24(17.14%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(7.85%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe table correlates diabetes type with recurrent DKA episodes after discharge. Those with Type 1 Diabetes had the highest recurrence of DKA (42.14%) and also Low Percentage Only 7.85% of individuals with Type 2 Diabetes experienced recurrent DKA. The P-value of (0.011) suggests a statistically significant.\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e: \u003cb\u003ebivariate analysis Correlation between excessive thirst prior to the DKA episode and regularly monitor blood glucose levels at home\u003c/b\u003e The Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e examines the correlation between experiencing excessive thirst prior to a diabetic ketoacidosis (DKA) episode and regularly monitoring blood glucose levels at home, with a p-value of 0.778 indicating no statistically significant association between the two variables. Among patients who experienced excessive thirst before the DKA episode, 42.1% did not regularly monitor their blood glucose levels at home, while 50.7% did. For those who did not experience excessive thirst prior to the episode, 3.7% did not regularly monitor their blood glucose, and 3.57% did.The p-value suggests that there is no significant correlation between having excessive thirst before a DKA episode and the practice of regularly monitoring blood glucose levels at home.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ebivariate analysis correlation between excessive thirst prior to the dka episode and regularly monitor blood glucose levels at home\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eDo you regularly monitor your blood glucose levels at home?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eexcessive thirst prior to the DKA episode\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategories\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.778\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59(42.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e71(50.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(3.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(3.57%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e: \u003cb\u003ebivariate analysis Correlation Between Insulin Therapy and Recurrent DKA Episodes\u003c/b\u003e The table presents the correlation between receiving insulin therapy during diabetic ketoacidosis (DKA) treatment and having a recurrent episode of DKA after discharge, with a p-value of 0.0 indicating a statistically significant association. Among patients who received insulin therapy during their DKA treatment, 50% experienced a recurrent episode of DKA after discharge, and 50% did not. The p-value of 0.0 suggests a significant correlation between receiving insulin therapy and the likelihood of experiencing recurrent DKA episodes, although further details would be necessary to understand the nature and direction of this relationship.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ebivariate analysis correlation between insulin therapy during dka treatment and recurrent episode of dka after discharge\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eHave you had a recurrent episode of DKA after discharge?\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003einsulin therapy during your DKA treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategories\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.0\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e70(50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70(50%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e: \u003cb\u003ebivariate analysis Correlation between excessive thirst prior to the DKA episode and regularly monitor blood glucose levels at home.\u003c/b\u003e The table explores the correlation between having other chronic illnesses and experiencing a recurrent episode of diabetic ketoacidosis (DKA) after discharge, with a p-value of 0.011 indicating a statistically significant association. Among patients with chronic illnesses, 0% with renal diseases experienced recurrent DKA, while 0.71% did. For those with hypertension, 10% did not experience recurrent DKA, and 5% did. Among patients with chronic respiratory diseases, 2.1% did not experience recurrent DKA, and 0.71% did. Those with chronic liver diseases had 2.8% without recurrent DKA and none with recurrent episodes. Similarly, 2.8% of patients with cardiovascular diseases did not experience recurrent DKA, and none did. For patients without any chronic illnesses, 32.1% did not experience recurrent DKA, while 43.5% did. The significant p-value suggests that the presence of other chronic illnesses is associated with the likelihood of having a recurrent episode of DKA after discharge.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e bivariate analysis correlation between other chronic illnesses and recurrent dka\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eHave you had a recurrent episode of DKA after discharge?\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003eOther chronic illnesses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCategories\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003eN (%)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes, renal diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(0.71%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes, hypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14(10%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7(5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes, chronic respiratory disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(2.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1(0.71%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes, chronic liver diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(2.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes, cardiovascular diseases\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(2.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45(32.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e61(43.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e:\u003cb\u003eMultivariate analysis of missing insulin doses and the socio-demographic characteristics\u003c/b\u003e The multivariate analysis explores the relationship between missing insulin doses and various socio-demographic characteristics. The results are summarized as follows: For age group, the p-value is 0.354, with an adjusted odds ratio (AOR) of 0.906 and a 95% confidence interval (CI) ranging from 0.735 to 1.117. This indicates that age group is not significantly associated with missing insulin doses.Gender has a p-value of 0.673, with an [AOR of 1.178 and a 95% CI of 0.550 to 2.522]. This suggests no significant association between gender and the likelihood of missing insulin doses.Marital status shows a p-value of 0.410, with an [AOR of 1.258 and a 95% CI ranging from 0.728 to 2.173], indicating no significant relationship between marital status and missing insulin doses. The highest level of education has a p-value of 0.001, with an [AOR of 0.511 and a 95% CI of 0.341 to 0.768]. This suggests that individuals with higher levels of education are significantly less likely to miss insulin doses.Employment status has a p-value of 0.143, with an [AOR of 0.756 and a 95% CI ranging from 0.519 to 1.099]. This indicates no significant association between employment status and missing insulin doses.Monthly household income has a p-value of 0.729, with an [AOR of 1.067 and a 95% CI ranging from.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003emultivariate analysis of missing insulin doses and the socio-demographic characteristics\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAOR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e95% Confidence Interval\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLower\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eupper\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eage group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.354\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.906\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.735\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.117\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003egender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.673\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.178\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.550\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.522\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003emarital status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.410\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.258\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.728\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.173\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ehighest level of education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.511\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.341\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.768\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eemployment status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.143\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.756\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.519\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.099\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003emonthly household income\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.729\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.067\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.739\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.542\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eThe study reveals that diabetic ketoacidosis (DKA) is predominantly affecting younger individuals, with 37.1%) of patients aged under 18 years having developed DKA. About 65,000 children under 15 years develop type 1 diabetes each year, with up to 80% presenting with DKA. A significant number of patients have no formal education, which may impact their ability to understand and manage diabetes. DKA is more prevalent among people with type 1 diabetes and can also develop in people with type 2 diabetes. The majority of patients have been hospitalized for DKA at least once in the past year, with 92.9% reporting excessive thirst and 97.1% experiencing frequent urination. Abdominal pain is another common symptom, with abdominal pain being the most common. Insulin therapy and antibiotics are the standard of care, with intravenous insulin by continuous infusion being the standard of care.Physical exercise is practiced daily by 57.9% of patients, and 80.7% are non-smokers. Recent infections are reported by 72.1%, while 73.6% have no other chronic illnesses. Stress or emotional distress is experienced by 62.1%, and 58.6% have not received education on managing sick days. The study also found a significant correlation between education level and health literacy regarding diabetes management. Patients with higher education levels were more likely to have a better understanding of diabetes management, while those with poor understanding of DKA symptoms had the lowest confidence.\u003c/p\u003e"},{"header":"5. CONCLUSION","content":"\u003cp\u003eAs highlighted in our study, focused on the sociodemographic determinants, clinical presentations, management outcomes, and risk factors and predictors. To tackle these factors, the findings of this study underscore the importance of socio-demographic factors, education, and lifestyle choices in the management and outcomes of diabetes and DKA. The significant associations between education, employment, and health literacy suggest that targeted interventions to improve education and employment opportunities may positively impact diabetes management. Additionally, the role of physical activity and psychological well-being in reducing hospital stays and preventing recurrent DKA episodes should be prioritized in future interventions. These results highlight the need for a comprehensive approach to diabetes care that considers socio-economic, psychological, and lifestyle factors.\u003c/p\u003e"},{"header":"6. RECOMMENDATION","content":"\u003cp\u003eThe text emphasizes the importance of enhancing diabetes education, promoting regular insulin use, improving access to diabetes medications, promoting a diabetes-specific diet, strengthening physical activity, addressing psychological stress, enhancing monitoring in healthcare settings, improving understanding of DKA symptoms, addressing socio-demographic disparities, integrating chronic illness management with diabetes care, monitoring and adjusting interventions based on patient feedback, increasing support for newly diagnosed patients, promoting regular healthcare visits, fostering community engagement, and evaluating and improving healthcare systems. These strategies aim to improve patient outcomes, reduce barriers to care, improve patient-provider communication, and ensure responsiveness to the needs of diabetic patients. By addressing these aspects, the healthcare system can better address the needs of diabetic patients and promote overall health.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAli Y, Rashid O, Ehsan P, Wireko AA, Abdul-Rahman T, Khan M, Islam N (2023) \u003cem\u003eGender Related Differences in Clinical Presentation and Outcomes of Diabetic Ketoacidosis: A Retrospective Study\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.21203/rs.3.rs-3824590/v1\u003c/span\u003e\u003cspan address=\"10.21203/rs.3.rs-3824590/v1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAtkilt HS, Turago MG, Tegegne BS (2017) Clinical Characteristics of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes in Addis Ababa, Ethiopia: A Cross-Sectional Study. 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Diabetes Care 37(11):3124\u0026ndash;3131. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2337/dc14-0984\u003c/span\u003e\u003cspan address=\"10.2337/dc14-0984\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePerel P, Roberts I, Ker K (2013) Colloids versus crystalloids for fluid resuscitation in critically ill patients. \u003cem\u003eThe Cochrane Database of Systematic Reviews\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e, CD000567. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/14651858.CD000567.pub6\u003c/span\u003e\u003cspan address=\"10.1002/14651858.CD000567.pub6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":" AL HAYAT MEDICAL UNIVERSITY","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Diabetic ketoacidosis, Type 1diabetes, Mogadishu, Risk factors, Clinical characteristics, Insulin therapy, Diabetes management","lastPublishedDoi":"10.21203/rs.3.rs-8038111/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8038111/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eDiabetic ketoacidosis (DKA) is a severe complication primarily affecting type 1 diabetes patients, though it can also occur in type 2 diabetes. In Somalia, decades of conflict have weakened the healthcare system, limiting access to regular diabetes care and education, which heightens the risk of DKA. This study explores the epidemiological and clinical characteristics of DKA in diabetic patients at hospitals in Mogadishu, Somalia, to identify patterns, risk factors, and outcomes.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional study was conducted at Aden Cade, Kalkal, and Martini hospitals involving 140 diabetic patients with DKA. Data were gathered through structured questionnaires and clinical records, and statistical analysis was done using SPSS to assess sociodemographic determinants, clinical presentations, and risk factors for DKA.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e\u003cp\u003eThe majority of patients were under 18 years old, with 75% having type 1 diabetes. Common symptoms included excessive thirst (92.9%), frequent urination (97.1%), and abdominal pain (95.7%). All patients received insulin therapy, and most were also treated with antibiotics. Half of the patients experienced recurrent DKA episodes after discharge, indicating a need for improved diabetes management and follow-up care\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eremains a significant public health issue in Mogadishu due to limited healthcare access, insufficient patient education, and poor insulin to treatment. Addressing these challenges through better healthcare infrastructure, patient education, and management protocols could reduce DKA occurrences in Somalia.\u003c/p\u003e","manuscriptTitle":"Epidemiological and Clinical Characteristics of Diabetic Ketoacidosis Among Diabetic Patients in Mogadishu, Somalia.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-06 09:11:56","doi":"10.21203/rs.3.rs-8038111/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"95cf1ade-98e3-4f1b-9856-c9ad3f503c18","owner":[],"postedDate":"November 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":57483817,"name":"Internal Medicine"}],"tags":[],"updatedAt":"2025-11-06T09:11:56+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-06 09:11:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8038111","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8038111","identity":"rs-8038111","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}