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2026, Vol: 10, Issue: 8
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Original Article
Online Published: 30 Jul 2026
 


A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors

Isaq Ali Almughaizel, Yassin Alsaleh, Mohammed Alhabeeb, Fatimah Mouayed Aljishi, Abdullah Alkhamis, Jalal Aldandan, Hussain Alturkey, Ahmed Alkhalifah.


Abstract
Objective: This study aimed to describe the incidence, temporal trends, and risk factors for diabetic ketoacidosis (DKA) admissions in a pediatric intensive care unit (PICU) in Saudi Arabia.
Methods: A retrospective analysis was conducted between April 2013 and March 2018. A total of 270 PICU admissions were recorded for 159 unique patients. Mean age at admission was 9.6 ± 3.4 years; 63.0% of admissions were females. Data on demographics, clinical presentations, and temporal factors were analyzed.
Results: Most admissions (80.4%) known to have type 1 diabetes mellitus, while 19.6% were newly diagnosed. A subset (36.5%) had multiple admissions. Patients with recurrent admissions presented with higher glucose levels (560.5 vs. 459.2 mg/dl, p-value = 0.037), larger family size (6.2 vs. 4.6 members, p-value = 0.006), and shorter PICU stays (14.1 vs. 19.0 hours, p-value = 0.022). Orphans and children from very large families (≥10 members) had significantly higher recurrence (p-value<0.05). Newly diagnosed patients were younger and had longer stays (20.8 vs. 14.7 hours, p-value = 0.002). DKA severity was the strongest predictor of prolonged stay (severe: 24.4 vs. mild: 11.1 hours, p-value < 0.001). Admissions significantly increased during Ramadan (p-value < 0.001) and school vacations (p-value < 0.001), with a rising annual trend over the 5-year study period.
Conclusion: This study identified larger family size, orphan status, and specific temporal periods (Ramadan, vacations) as key risk factors for recurrent and severe DKA, highlighting the need for targeted social and educational interventions during high-risk times.

Key words: Diabetic ketoacidosis, type 1 diabetes mellitus, pediatric intensive care unit, school vacations, Ramadan, risk factors, Saudi Arabia


 
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How to Cite this Article
Pubmed Style

Almughaizel IA, Alsaleh Y, Alhabeeb M, Aljishi FM, Alkhamis A, Aldandan J, Alturkey H, Alkhalifah A. A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. IJMDC. 2026; 10(8): 2043-2055. doi:10.24911/IJMDC.51-1770381497

Web Style

Almughaizel IA, Alsaleh Y, Alhabeeb M, Aljishi FM, Alkhamis A, Aldandan J, Alturkey H, Alkhalifah A. A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. https://www.ijmdc.com/?mno=309555 [Access: August 25, 2026]. doi:10.24911/IJMDC.51-1770381497

AMA (American Medical Association) Style

Almughaizel IA, Alsaleh Y, Alhabeeb M, Aljishi FM, Alkhamis A, Aldandan J, Alturkey H, Alkhalifah A. A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. IJMDC. 2026; 10(8): 2043-2055. doi:10.24911/IJMDC.51-1770381497


Vancouver/ICMJE Style

Almughaizel IA, Alsaleh Y, Alhabeeb M, Aljishi FM, Alkhamis A, Aldandan J, Alturkey H, Alkhalifah A. A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. IJMDC. (2026), [cited August 25, 2026]; 10(8): 2043-2055. doi:10.24911/IJMDC.51-1770381497


Harvard Style

Almughaizel, I. A., Alsaleh, . Y., Alhabeeb, . M., Aljishi, . F. M., Alkhamis, . A., Aldandan, . J., Alturkey, . H. & Alkhalifah, . A. (2026) A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. IJMDC, 10 (8), 2043-2055. doi:10.24911/IJMDC.51-1770381497


Turabian Style

Almughaizel, Isaq Ali, Yassin Alsaleh, Mohammed Alhabeeb, Fatimah Mouayed Aljishi, Abdullah Alkhamis, Jalal Aldandan, Hussain Alturkey, and Ahmed Alkhalifah. 2026. A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. International Journal of Medicine in Developing Countries, 10 (8), 2043-2055. doi:10.24911/IJMDC.51-1770381497


Chicago Style

Almughaizel, Isaq Ali, Yassin Alsaleh, Mohammed Alhabeeb, Fatimah Mouayed Aljishi, Abdullah Alkhamis, Jalal Aldandan, Hussain Alturkey, and Ahmed Alkhalifah. "A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors." International Journal of Medicine in Developing Countries 10 (2026), 2043-2055. doi:10.24911/IJMDC.51-1770381497


MLA (The Modern Language Association) Style

Almughaizel, Isaq Ali, Yassin Alsaleh, Mohammed Alhabeeb, Fatimah Mouayed Aljishi, Abdullah Alkhamis, Jalal Aldandan, Hussain Alturkey, and Ahmed Alkhalifah. "A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors." International Journal of Medicine in Developing Countries 10.8 (2026), 2043-2055. Print. doi:10.24911/IJMDC.51-1770381497


APA (American Psychological Association) Style

Almughaizel, I. A., Alsaleh, . Y., Alhabeeb, . M., Aljishi, . F. M., Alkhamis, . A., Aldandan, . J., Alturkey, . H. & Alkhalifah, . A. (2026) A retrospective study of diabetic ketoacidosis in the pediatric intensive care unit: incidence, temporal patterns, and risk factors. International Journal of Medicine in Developing Countries, 10 (8), 2043-2055. doi:10.24911/IJMDC.51-1770381497




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