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Saudi Med J. 2015 Jan;36(1):20-5. doi: 10.15537/smj.2015.1.9763.

Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia.

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Department of Pediatrics, King Abdulaziz Medical City, PO Box 22490, Riyadh 11426, Kingdom of Saudi Arabia. Tel. +966 (11) 8011111 Ext. 12841. Fax. +966 (11) 2520088 Ext. 11640. E-mail.



To evaluate the clinical and biochemical characteristics of children with diabetic ketoacidosis (DKA).


In this retrospective study conducted between June 2012 and November 2013 at the King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, we evaluated pediatric DKA admissions from 1995-2008 (Phase 1). From the case files, we obtained information related to patients' age, gender, weight, presenting complaints, serum biochemical profile, and management.


This study included 373 DKA admissions with a median age of 11 years (interquartile range [IQR]: 8-13). The patients in the subgroup of age more than 10 years old had the highest proportion of admissions (n=250, 67%, p<0.000). The median duration of diagnosis of diabetes mellitus (DM) was 3 years (IQR: 2-6). New-onset DM was 47%. Predominant precipitating cause was acute illness, mostly viral syndrome in 22% of all cases, and non-compliance to insulin regimen was in 79% of  the diagnosed diabetic cases. Blood glucose, pH, anion gap, serum osmolality, serum potassium, and serum phosphate showed the highest change during the initial 6 hours of management, while trends of serum bicarbonate and blood urea nitrogen demonstrated a predominant change in the initial 12 hours.


The notable findings in this study, such as, higher mean age of presentation, high rate of non-compliance to insulin as the cause of precipitation, and a high prevalence of abdominal pain at presentation should be followed up with further comparative studies.

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