Burden and Complications of Pediatric Diabetic Ketoacidosis: A Study from a Tertiary Care Pediatric ICU in Tripoli, Libya

Objective: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of type 1 diabetes (T1D) and is associated with complications at presentation or during its treatment. However, there is a lack of data on the frequency of DKA-related complications among Libyan children with T1D. This study aimed to determine the frequency of DKA-related complications among children with T1D admitted to the pediatric intensive care unit (PICU) at Tripoli Children’s Hospital, Libya, from 2015 to 2018.

Materials and Methods: A retrospective cohort study was conducted on children aged 0.5- 17 years admitted with DKA. Data were analyzed to estimate the frequency of recurrent DKA and complications, including acute kidney injury (AKI), electrolyte abnormalities, and cerebral edema (CE).

Results: Over 4 years, 103 DKA episodes in 91 children were analyzed. Females accounted for 73.8% of cases, and 68.9% had established T1D. Recurrent DKA occurred in 45.1% of children with established T1D, predominantly in females and adolescents. Complications occurred in 66.0% of episodes, with AKI being the most frequent (61.8%), followed by electrolyte abnormalities (sodium 36.4%, potassium 34.7%). Two cases of CE (1.94%) were documented, with no reported mortality.

Conclusion: Recurrent DKA and complications, particularly AKI, are prevalent among Libyan children admitted to the PICU. These findings highlight the critical importance of early diagnosis, optimized outpatient care, and structured patient education in reducing the recurrence of DKA and its associated complications.

Cite this article as: Shebani MS, Khashebi RM. Burden and complications of pediatric diabetic ketoacidosis: A study from a tertiary care pediatric ICU in Tripoli, Libya. Turk Arch Pediatr. Published online December 22, 2025. doi:10.5152/TurkArchPediatr.2025.25154.