Seasonal Variation of Diabetic Ketoacidosis among Children and Adolescents with Type 1 Diabetes:

Objectives: Diabetic ketoacidosis (DKA) seasonal variations among children and adolescents with type 1 diabetes mellitus (T1DM) have been widely studied; however, findings remain inconsistent. Although several studies reported a higher incidence during colder months, others showed no consistent patterns. This study investigated whether DKA frequency and severity vary across seasons, particularly in humid cities. Methods: This retrospective cohort analyzed children and adolescents with T1DM admitted to a tertiary hospital with DKA (2015-2025). Data included demographics, seasonal admission trends, clinical severity, and outcomes. Statistical analyses involved the Chi-square and ANOVA tests. Results: A total of 369 DKA cases were analyzed, with mean age of 14.7 years and 62.6% were females. Most had established T1DM (88.6% with prior DKA episodes). Severe cases showed significantly higher heart rates, lower GCS scores ( Conclusions: The DKA admission peaked in winter, particularly in December; however, this trend was not clinically significant. Confounding factors, including infection or delayed care, may explain this variation. The findings emphasize focusing on modifiable patient factors, including year-round glycemic control, education, and timely interventions, to reduce DKA recurrence.