Prevalence, Clinical Profile, and Outcomes of Diabetic Ketoacidosis (DKA) in Pediatric ICU Patients in the Middle East: A Systematic Review and Meta-Analysis

Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes mellitus (T1DM) in children. While the global incidence is rising, data on the clinical profile and outcomes of pediatric DKA specifically within intensive care units (ICUs) in the Middle East remain fragmented. This systematic review and meta-analysis aimed to synthesize evidence on the prevalence, severity, and clinical outcomes of DKA in pediatric ICU settings across the region. PubMed, Embase, Scopus, Web of Science, and WHO Global Index Medicus were searched for observational studies published from January 2000 to December 2025. Studies were included if they reported on pediatric patients (0-18 years) with DKA admitted to ICUs in Middle Eastern countries. Two reviewers independently screened the studies, extracted data, and assessed their quality using the Joanna Briggs Institute (JBI) checklist and Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted to estimate the pooled prevalence and clinical parameters. Six studies comprising 919 pediatric patients from Saudi Arabia, Egypt, and Iran met the inclusion criteria. The pooled prevalence of severe DKA (pH