Diabetic ketoacidosis (DKA) is one of the most serious acute complications of diabetes mellitus in children, often leading to severe dehydration, altered consciousness, and death if not promptly managed. The burden of DKA is increasing globally and in Ethiopia, placing substantial strain on pediatric emergency and inpatient care services. Despite its clinical and public health importance, evidence on time to resolution of DKA and its predictors remains limited in Ethiopia, particularly in the northeastern region. This study aimed to assess the time to resolution of DKA and its predictors in children with type 1 diabetes. A retrospective follow-up study was conducted using 494 medical records of children with type 1 diabetes mellitus treated at Dessie Comprehensive Specialized Hospital between January 1, 2020, and December 31, 2024. Patient charts were selected using a simple random sampling technique. Data were extracted through a structured checklist based on registry and medical chart reviews. Kaplan–Meier survival analysis was employed to estimate time to resolution from DKA, and differences in survival distributions across categories of explanatory variables were assessed using the log-rank test. Cox proportional hazards regression was applied to identify predictors of time to resolution of DKA. Variables with a p-value 500 mg/dL (AHR = 0.77; 95% CI: 0.62–0.96), presence of infection (AHR = 0.65; 95% CI: 0.47–0.90), newly diagnosed diabetes mellitus (AHR = 0.79; 95% CI: 0.63–0.99 and DKA duration ≥ 24 h (AHR = 0.08; inverse of 500 mg/dL, presence of infection and newly diagnosed diabetes had negative relationship (delayed resolution) while mild DKA severity, and duration of DKA < 24 h had positive relationship (faster resolution). These findings highlight the need for healthcare providers and caregivers to address these factors to accelerate resolution and improve clinical outcomes. Clinical trial number: Not applicable.
Abegaz et al. (Fri,) studied this question.