What We Know About Diabetic Ketoacidosis Risk in Type 1 Diabetes

Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus. It occurs when blood sugar levels become dangerously high and the body produces excess acids called ketones, disrupting the body's chemistry. DKA is a medical emergency requiring immediate hospital care.

While DKA is well-known as a complication of diabetes, researchers have had limited data on exactly how often it occurs and who is at highest risk—especially in parts of the world like Ethiopia where detailed health records are less common.

Researchers reviewed records of 419 diabetes patients who received care at public health centers in Addis Ababa, Ethiopia between 2018 and 2022. Over the five-year follow-up period, 114 patients (27.2%) developed diabetic ketoacidosis.

The study used statistical methods to identify which factors most strongly predicted DKA. The analysis revealed three independent risk factors: having Type 1 diabetes, a history of not taking prescribed medications, and poor blood sugar control over the prior six months.

Patients with Type 1 diabetes had a notably higher risk of developing DKA compared to those with Type 2 diabetes. People with a history of medication noncompliance—meaning they skipped or didn't regularly take their prescribed drugs—had the highest adjusted risk. Recent poor glycemic control, meaning blood sugar levels had been consistently high in the six months before the event, also strongly predicted DKA development.

These findings suggest that DKA risk is not random; it is closely linked to modifiable behaviors and medical management.

This study emphasizes why consistent medication use and regular blood sugar monitoring matter so much for Type 1 diabetes management. DKA is preventable through good diabetes care—and this research identifies the specific gaps that increase risk.

If you or a loved one lives with Type 1 diabetes, these findings underscore the value of working closely with your healthcare team, taking medications as prescribed, and tracking blood sugar trends. If medication adherence is a challenge, talking openly with your provider about barriers can help you find solutions that work for your life.

Source: BMC endocrine disorders. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.