Background and objective Diabetic ketoacidosis (DKA) remains a major acute complication in patients with type 1 diabetes. Despite advances in diabetes management, recurrent DKA remains an issue and is often driven by knowledge gaps in symptom recognition, management awareness, and adherence to recommended self-care practices. We aimed to assess awareness of DKA symptoms, management, and diabetes-related complications, as well as adherence to recommended care practices among patients with type 1 diabetes attending outpatient clinics at King Fahad Specialist Hospital (KFSH) in Buraidah, Saudi Arabia. Methodology This cross-sectional study included 206 patients with type 1 diabetes. Data were collected through a structured questionnaire that evaluated participants' awareness of DKA symptoms, its management and prevention, diabetes-related complications, and adherence to recommended diabetes self-care practices. Descriptive statistics, correlation analyses, and comparative analyses across different sociodemographic groups were conducted. Results Of the 206 patients, 104 (50.5%) were aged 21-25 years, and 114 (55.3%) were men. Awareness of DKA symptoms was moderate in 130 (63.1%) patients, and awareness of DKA management and prevention was also predominantly moderate in 148 (71.8%) patients, whereas awareness of diabetes-related complications was generally poor, with only 46 (22.3%) patients demonstrating moderate knowledge. Adherence was moderate among 112 (54.4%) patients, with stronger adherence to clinical follow-up practices than to lifestyle-related behaviors. Significant positive correlations were observed between all awareness domains and adherence (p < 0.01). Women had significantly higher awareness of DKA symptoms (p = 0.046) and significantly higher adherence to diabetes care (p < 0.001). Insulin pump users demonstrated markedly higher awareness across all domains (p < 0.001) and higher adherence (p = 0.021). Patients with HbA1c ≤ 8% also showed significantly higher awareness of DKA symptoms and management (p < 0.05) and substantially better adherence (p < 0.001). Awareness of diabetes complications was significantly higher among older patients (aged ≥ 26 years; p = 0.009) and those with higher education (p = 0.018). Conclusions Important gaps in patient awareness of severe DKA symptoms, secondary precipitation factors, and diabetes-related complications were observed. Clinical monitoring practices were generally adequate, but lifestyle adherence was limited. Women, insulin pump users, and patients with optimal glycemic control (HbA1c ≤ 8%) consistently demonstrated higher awareness and adherence, suggesting an association with better diabetes self-management. The strong association between awareness and adherence highlights the need for structured, repeated, and culturally sensitive diabetes education programs. Increasing patient and caregiver knowledge may improve diabetes self-management and may potentially contribute to reducing DKA recurrence and improving long-term outcomes.
Fattouta et al. (2026) studied this question.