Ketosis Decompensations at the National Hospital in Benin (West Africa), What Did We Learn about the Precipitating Factors?

Abstract

We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.