Characteristics and outcome of ketoacidosis in Libyan diabetic patients

The characteristics and outcome of 100 consecutive cases of diabetic ketoacidosis (DKA) in Libyan diabetic patients studied over a six month period are reported. Moderate to severe diabetic ketoacidosis was included (M:51, F:49). Seventy‐eight percent of the episodes were in patients with known diabetes. Ninety‐five percent of patients with DKA were classified as having type 1 diabetes mellitus. Compared to female patients, the male patients had a significantly lower Body Mass Index (BMI) (20.9 vs 22.5 Kg/m², p < 0.001) and more clinically underweight male subjects were identified (20/51 vs 6/49, p < 0.01). The most common cause of DKA was stopping insulin therapy, which occurred in 41% of the episodes, followed by first presentation and infection. A trend towards more male subjects stopping insulin was observed. Mortality was 2%. We conclude that the majority of cases of DKA in Libyan diabetic patients is potentially avoidable by simple education and is associated with a low mortality. Sex‐related features of patients with DKA are suggestive of a ‘male attitude diabetes syndrome’.