Diabetic ketoacidosis (DKA) remains a major cause of pediatric emergency admissions and diabetes-related complications in children with type 1 diabetes mellitus (T1DM). A retrospective follow-up study published in BMC Endocrine Disorders evaluated time to DKA resolution and associated predictors among children with T1DM treated at Dessie Comprehensive Specialized Hospital in Ethiopia.

The study reviewed 494 medical records from January 2020 through December 2024. A total of 487 children were included in the final analysis and were followed for 12,279 person-hours of observation. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to assess time to DKA resolution and associated clinical factors.

Findings

• Among 487 children with type 1 diabetes, 406 recovered from diabetic ketoacidosis (DKA), yielding an overall resolution proportion of 83.37% (95% CI, 80.06-86.67).
• The incidence rate of DKA resolution was 3.30 per 100 person-hours (95% CI, 2.99-3.64), with a median resolution time of 22 hours (95% CI, 18.32-25.67).
• Baseline random blood sugar (RBS) above 500 mg/dL was associated with delayed DKA resolution (adjusted hazard ratio [AHR], 0.77; 95% CI, 0.62-0.96).
• Presence of infection was linked to longer time to DKA resolution (AHR, 0.65; 95% CI, 0.47-0.90).
• Newly diagnosed diabetes mellitus was associated with slower recovery from DKA (AHR, 0.79; 95% CI, 0.63-0.99).
• Mild DKA severity and DKA duration below 24 hours were associated with faster resolution (AHR, 1.37; 95% CI, 1.01-1.84 and AHR, 11.96; 95% CI, 7.71-18.55, respectively).

The study showed that infection, severe hyperglycemia, and newly diagnosed diabetes were associated with slower DKA recovery in children with T1DM. Earlier presentation and milder DKA severity were linked to faster resolution.