ArticleSouth African family practice : official journal of the South African Academy of Family Practice/Primary Care2022
COVID-19 and diabetic ketoacidosis: A case series at an urban district hospital in South Africa.
Article in South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 3 citations in OpenAlex.
- Unraveling A-β+ ketosis-prone diabetes: An evolving diagnosis with an elusive pathogenesis.Journal of diabetes investigation · 2026Review
- Mapping the storm: a scoping review of diabetic emergencies in Africa.Frontiers in clinical diabetes and healthcare · 2026Review
- Diabetic Ketoacidosis and COVID-19: Patient profiles from a regional emergency department in Johannesburg, South Africa.Journal of the colleges of medicine of South Africa · 2025Article
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2 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronavirus disease 2019 (COVID-19) is associated with an increased prevalence and mortality from diabetic ketoacidosis (DKA) globally. With limited access to specialised care, most patients with DKA in South Africa are managed at district hospital level. This study describes the profile of patients admitted to a district hospital in South Africa with DKA and COVID-19 and examines associated risk factors encountered.
methodsThis was a case series of all patients presenting to a district hospital with DKA and COVID-19 infection between July 2020 and July 2021. Data extracted included patients' demographic profiles, biochemical results, comorbidities and clinical outcomes.
resultsThe median age of the 10 patients admitted during the study period was 39 years old (±12), six of whom were male. The hemoglobin A1c (HbA1c) values on admission ranged from 9.7 to 13.8. Five of the patients had pre-existing type 2 diabetes mellitus (DM). Four of the known DM patients were on metformin only, and one was on biphasic insulin. Three patients had other pre-existing comorbidities, two patients with hypertension and one with human immunodeficiency virus (HIV). Three patients demised, two of whom were hypoxic on admission.
conclusionDiabetic ketoacidosis appears more commonly in COVID-19 infected patients with type 2 DM and at a young age. Suboptimal glycaemic control was associated with DKA, and hypoxia was a strong predictor for mortality. Treatment inertia was evident in the known DM group, who were on monotherapy despite persistent hyperglycaemia. Greater vigilance is required to detect ketosis in type 2 DM and intensify therapy to improve glycaemic control.
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