Incidence and mortality of diabetic ketoacidosis in Benghazi-Libya in 2007

The aim of this study was to estimate the incidence of diabetic ketoacidosis and the mortality rate at Benghazi city. A cross-sectional study of the records of all patients admitted with diabetic ketoacidosis to all Benghazi hospitals [governmental and private] between 1st of January and 31st of December 2007. The annual incidence of diabetic ketoacidosis was 41.7 episodes/100,000 populations with a mean age of 33 +/- 20.1 years [2-93]. Around 52% of all the episodes occurred in males and 2.6% of adult Diabetic ketoacidosis occurred in pregnant females. Type-2 diabetics were responsible for 27.7% of all episodes. The commonest precipitating factor in the whole study group was dose disruption [35%], followed by infection [20%]. The most common presenting symptoms were gastrointestinal, whilst 3.5% of the patients were comatose at presentation. The overall mortality was 11.7% and there was no significant difference in mortality between males and females [11% vs. 12.6%; p=0.6]; however, type-2 diabetics showed a significantly higher mortality rate [29.3% vs. 4.9%; p=0.000]. Diabetic ketoacidosis is a common condition in Libya with a high mortality rate and type-2 diabetics constitute a considerable number of the cases

Incidence of diabetic ketoacidosis during Ramadan fasting in Benghazi-Libya

Ramadan is the ninth month on the lunar calendar and it is a holy month for Muslims during which all healthy adults must fast from dawn to sunset. The risk of diabetic ketoacidosis is thought to be higher during Ramadan fasting due to insulin and glucagon alterations. A descriptive retrospective analysis of the records of all patients admitted with diabetic ketoacidosis to all Benghazi hospitals during the lunar year 1428 Hijri [2007-2008]. Fifteen episodes occurred during Ramadan compared to a mean of 19.45 episodes/months during the other lunar months [p<0.001], and there was no significant difference in the mean age [37.6 +/- 10 vs. 38.3 +/- 19, p= 0.8], mortality rate [13.3% vs. 14.4%, p=0.9] or in the length of hospitalization during Ramadan. The commonest precipitating factor for diabetic ketoacidosis during Ramadan was infection [46.6%] followed by miss dosing. There was no increase in the incidence and mortality from DKA during Ramadan which might indicate that Ramadan fasting is not a significant risk factor for diabetic ketoacidosis