P-52: Precipitating factors, clinical profile, and therapeutic outcomes of diabetic ketoacidosis in children and adolescents in two tertiary hospitals in Cameroon

Introduction

Diabetic ketoacidosis remain the main cause of admission and mortality in low income setting. With aim to study the prevalence, precipitating factors, clinical profile, and outcomes of Diabetic Ketoacidosis (DKA) in children and adolescents at Laquintinie Hospital Douala (LHD) and the Mother and Child Centre of the Chantal Biya Foundation (MCC-CBF) in Yaoundé, Cameroon.

Objectives

To analyse precipating factors of diabetes ketoacidosis in a low income country

Methods

We did a cross -sectional, in 2 diabetes clinics in Cameroon with data collected retrospectively. We collected data on 5 years ( January 1, 2020, to July 15, 2025) and included children and adolescents living with Type 1 Diabetes Mellitus (T1DM) aged 0 to 19 years who were admitted for DKA during the study period. We collected sociodemographic data, history of diabetes. Clinical and biological data were noted. And we noticed precipitating factors of DKA. Ethical clearance was obtained from the Institutional Ethical Review Board of the FMBS UY1.Data Analysis was done using R version 4.5.1 (2025-06-13 Universal C Runtime-UCRT).

Results

Diabetic ketoacidosis represented 63% (131/208) of all admission for diabtes. The median age of our study population was 12.9 years (IQR 10-15.1), known living with diabetes in 65.5% (n=84). The median duration of symptoms was 15 days (IQR IQR 5.05-43 days) with 28% of them presenting altered level of consciousness.

Infection was present in 72.4% (92/127) of patients. Among participants with infections, sepsis was the most common (52.2%), followed by malaria (42.3%), then upper respiratory tract infections (12%), and urinary tract infections (8.7%). Mortality rate was 5.5% (n=7), all were female adolescents who presented with severe sepsis with a mean age of 10.8 years. Five out of 7 were newly diagnosed.

Conclusions

DKA remains the main cause of admission for diabetes. Infection is the main precipitating factor. Mortality rate of DKA is 5.5% with severes sepsis as main comorbidity