Description
Background
Type 1 diabetes is rising in Kenya, with diabetic ketoacidosis (DKA) remaining the leading cause of hospitalization and mortality among children and adolescents. Integrated care approaches are essential to prevent first and recurrent episodes.
Objective
To describe the characteristics and outcomes of patients aged 0–25 years admitted with DKA.
Methods
A retrospective cross-sectional review was conducted for patients admitted with DKA at Kajiado County Referral Hospital between 2023–2025.
Results
Thirty-seven patients presented with 56 DKA episodes. Adolescents were most affected, with 41% aged 16–20 years and 38% aged 11–15 years; the male-to-female ratio was 1.6:1. Nearly half (44%) were newly diagnosed, 70% of whom were initially treated for infections before diabetes recognition. Among patients with pre-existing diabetes, 35% had recurrent DKA, with several admitted more than three times. Insulin omission was the main contributor, linked to hospital inaccessibility, stock-outs, psychosocial challenges, and demographic barriers. Forty percent were wasted (BMI <16 kg/m²). Most presented with moderate (65%) or mild (26%) DKA, and 94% had a GCS of 13–15. Median hospital stay was under 7 days, and one patient died from cerebral and pulmonary edema.
Conclusion
Delayed recognition, misdiagnosis, and insulin omission expose gaps in continuity of diabetes care. Strengthening integrated care models that link primary, community, and tertiary services, ensure reliable insulin supply, and provide psychosocial and socio-economic support is critical. Embedding equity-focused policies and social protection into NCD programs is essential to reduce preventable DKA admissions and improve survival among young people with type 1 diabetes.
| Country | Kenya |
|---|---|
| Organization | Government of Kenya |
| Position | Pediatric Endocrinologist |
| Received a Grant? | No |
| If yes, give grant details | NA |
