Paternal illiteracy is a Risk Factor for Severity of Diabetic Ketoacidosis in Children and Adolescents with Established Type 1 Diabetes: Single Center Experience

Background: Diabetic Ketoacidosis (DKA) is a life-threatening complication and a leading cause of hospitalization in patients with type 1 Diabetes (T1D).Aim of the work: to assess the effect of parental illiteracy and other demographic characteristics on severity of DKA in children and adolescents with T1D.Subjects and Methods: This cross-sectional study included 78 children and adolescents with established T1D recruited over 6 months, presenting with DKA at the Intensive Care Unit (ICU), Cairo University Children's Hospital, Cairo, Egypt.Results: The mean age ± SD of the study group was 9.90±2.01 years. The group comprised 40 (51.3%) males and 38 (48.7%) females with mean diabetes duration of 3.2±1.0 years. Mean duration of hospital stay was 7±2.01 days. None of the participants experienced complications, as cerebral edema or renal or hepatic impairment. DKA was precipitated by poor nutritional control in 32 (41.1%), intercurrent infections in 24 (30.8%) and 17 (21.8%) were non-compliant and skipped insulin doses (p=0.025, 0.032 and 0.01 respectively). Multinomial logistic regression revealed that the most significant predictors of the severity of DKA were the female sex, the lesser educational level of the father, low family income, diabetes duration, infection, poor diet control, non-compliance to insulin therapy (p= 0.028, p=0.007, p