Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Africa: a review

East African Medical Journal
C F OtienoG O Oyoo

Abstract

Diabetic ketoacidosis is the most common hyperglycaemic emergency in patients with diabetes mellitus, especially type 1 diabetes. It carries very high mortality in sub-Saharan Africa, both in the treated patients and those who are presenting to hospital with diabetes for the first time. To review the risk factors, mechanisms and management approaches in diabetes ketoacidosis in published literature and to discuss them in the context of why a significant proportion of patients who develop diabetic ketoacidosis in sub-Saharan Africa still have high mortality. Literature review of relevant published literature from both Africa and the rest of the world. The main causes or precipitants of DKA in patients in SSA are newly diagnosed diabetes, missed insulin doses and infections. The major underlying mechanism is insulin deficiency. Treated patients miss insulin doses for various reasons, for example, inaccessibility occasioned by; unavailability and unaffordability of insulin, missed clinics, perceived ill-health and alternative therapies like herbs, prayers and rituals. Infections also occur quite often, but are not overt, like urinary tract, tuberculosis and pneumonia. Due to widespread poverty of individuals and nations alike, the...Continue Reading

Citations

Mar 11, 2009·BMC Endocrine Disorders·Anthonia O OgberaOlufemi Fasanmade
Oct 1, 2008·International Journal of Diabetes in Developing Countries·Mario Azevedo, Sridevi Alla

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