Seasonal Trends, Clinical Profiles, and Outcomes of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes

Type 1 diabetes mellitus (T1DM) is the most common endocrine disorder in children, and diabetic ketoacidosis (DKA) remains its most serious acute complication. While seasonal variation in DKA incidence has been reported globally, such data are lacking from Pakistan, where the pattern is unknown. Objectives: To describe the seasonal trends, clinical profiles, and outcomes of DKA in children and adolescents. Methods: This descriptive, cross-sectional, retrospective study was conducted at the Department of Pediatrics, The Aga Khan University Hospital, Karachi. Data were collected from 1st November 2024 to 1st April 2025. Medical records were reviewed retrospectively from January 2019 to December 2022. Children of both genders aged 1–18 years, diagnosed with DKA either as newly diagnosed or known cases of T1Dm, were included. Demographic data, season at the time of presentation, laboratory parameters, clinical course, outcomes, and complications were recorded. The data were analyzed using R software. Results: A total of 78 cases were included, with a mean age of 9.6 ± 4.8 years. The mean hospital stay was 3 days. Most patients presented with severe DKA (55.1%). The highest frequency of cases occurred in winter (38.5%), followed by spring (24.4%), summer (23.1%), and autumn (14.1%). Autumn had the highest proportion of severe DKA (82%). Hyponatremia was the most common laboratory abnormality (47.43%). Conclusions: Seasonal variation showed slightly higher occurrence of DKA in winter, with most newly diagnosed children presenting with severe DKA. The majority of children (96.2%) had recovered.