Diabetic Ketoacidosis in Libya: Clinical Characteristics, Triggers, and Hospital Outcomes from a Tertiary Care Center

Abstract

Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication of diabetes, most commonly associated with type 1 diabetes. Understanding the clinical profile, factors, and outcomes of DKA is essential for timely intervention and effective management. This study aims to assess the clinical profile and precipitating factors of DKA among patients admitted to Misurata Medical Center, to improve early recognition and management strategies. A retrospective descriptive study was conducted on 113 patients diagnosed with DKA. Data were collected from hospital records and included demographic details, type of diabetes, presenting symptoms, biochemical parameters, precipitating factors, treatment modalities, and hospital outcomes. The mean age of patients was 27.7 years, with nearly half aged 20 or younger. The majority were female (55.8%) and had type 1 diabetes (98.2%). Insulin omission (49.1%) and infections (26.8%) were the most common precipitating factors. Common symptoms included nausea and vomiting (42.7%) and abdominal pain (17.5%). Severe hyperglycemia (≥400 mg/dL) and metabolic acidosis (pH ≤ 7.2) were present in more than half of patients. The vast majority recovered with short hospital stays (≤3 days in 90.3%). Recurrent DKA was reported in 50 %( 39/78 ) of cases, and complication rates were low (1.8%), with no in-hospital mortality. DKA remains a common and preventable acute complication of diabetes, particularly among young individuals with diabetes. Insulin omission and infection were the leading precipitating factors, suggesting gaps in adherence and patient education. The findings support the development of localized DKA management protocols and further research into long-term outcomes and risk factors.