{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T21:04:43Z","timestamp":1771275883367,"version":"3.50.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,16]]},"DOI":"10.7759\/cureus.103735","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T20:16:26Z","timestamp":1771272986000},"source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, Clinical Profile, and Outcomes of Diabetic Ketoacidosis (DKA) in Pediatric ICU Patients in the Middle East: A Systematic Review and Meta-Analysis"],"prefix":"10.7759","author":[{"given":"Niemat M","family":"Ali","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa H","family":"Alhag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alam E","family":"Mustafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahd H","family":"Altowairgi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafie","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed F","family":"Asiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massa M","family":"Alsaidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed I","family":"Alshanqiti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisham Naeem","family":"Jamil Abusamra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A","family":"Abu Diyyah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabbaa M","family":"Almuyidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salman M","family":"Alshammari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz M","family":"Alshammari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Beda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwh A","family":"Alzubair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-25519-9_44","article-title":"Hyperglycemic crises: diabetic ketoacidosis","author":"Moazzami B","year":"2023","unstructured":"Moazzami B, Zabala ZE, Umpierrez GE. Hyperglycemic crises: diabetic ketoacidosis.  The Diabetes Textbook. Rodriguez-Saldana J (ed): Springer Nature Switzerland, Cham; 2023. 699-709. 10.1007\/978-3-031-25519-9_44"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2009.00569.x","article-title":"Diabetic ketoacidosis in children and adolescents with diabetes","volume":"10","author":"Wolfsdorf J","year":"2009","unstructured":"Wolfsdorf J, Craig ME, Daneman D, et al.. Diabetic ketoacidosis in children and adolescents with diabetes. Pediatr Diabetes. 2009, 10:118-33. 10.1111\/j.1399-5448.2009.00569.x","journal-title":"Pediatr Diabetes"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2015.1.9763","article-title":"Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia","volume":"36","author":"Naeem MA","year":"2015","unstructured":"Naeem MA, Al-Alem HA, Al-Dubayee MS, Al-Juraibah FN, Omair A, Al-Ruwaili AS, Al-Saleh AM. Characteristics of pediatric diabetic ketoacidosis patients in Saudi Arabia. Saudi Med J. 2015, 36:20-5. 10.15537\/smj.2015.1.9763","journal-title":"Saudi Med J"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-012-2690-2","article-title":"Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review","volume":"55","author":"Usher-Smith JA","year":"2012","unstructured":"Usher-Smith JA, Thompson M, Ercole A, Walter FM. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia. 2012, 55:2878-94. 10.1007\/s00125-012-2690-2","journal-title":"Diabetologia"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-59873-9_40","article-title":"Pediatric critical care","author":"Sanders S","year":"2024","unstructured":"Sanders S, Lull J, Daniel M, Stewart C. Pediatric critical care. Pediatric Rotations: A Quick Guide for Medical Students. Liao N, Mahan J, Misra S, Scherzer R, Schiller J (ed): Springer Nature , Cham, Switzerland; 2024. 537-51. 10.1007\/978-3-031-59873-9_40"},{"key":"ref6","article-title":"Diabetic ketoacidosis (DKA)","author":"Aydin A","year":"2024","unstructured":"Aydin A, Joseph D, Joseph M. Diabetic ketoacidosis (DKA). Simulation in EMS and Critical Care Transport. Springer Nature Switzerland, Cham; 2024. 315-24."},{"key":"ref7","article-title":"Evaluating the effectiveness of modern treatment protocols in managing diabetic ketoacidosis In intensive care units: a systematic review","volume":"21","author":"Ismail MA","year":"2025","unstructured":"Ismail MA, Bali ME, Alturaifi AH, et al.. Evaluating the effectiveness of modern treatment protocols in managing diabetic ketoacidosis In intensive care units: a systematic review. The Review of Diabetic Studies. 2025, 21:475-85.","journal-title":"The Review of Diabetic Studies"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200101253440404","article-title":"Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics","volume":"344","author":"Glaser N","year":"2001","unstructured":"Glaser N, Barnett P, McCaslin I, et al.. Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. N Engl J Med. 2001, 344:264-9. 10.1056\/NEJM200101253440404","journal-title":"N Engl J Med"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1414","article-title":"Incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado youth, 1998-2012","volume":"313","author":"Rewers A","year":"2015","unstructured":"Rewers A, Dong F, Slover RH, Klingensmith GJ, Rewers M. Incidence of diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado youth, 1998-2012. JAMA. 2015, 313:1570-2. 10.1001\/jama.2015.1414","journal-title":"JAMA"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-025-04178-0","article-title":"Risk factors of acute kidney injury in children with diabetic ketoacidosis","volume":"26","author":"Alyahyawi N","year":"2025","unstructured":"Alyahyawi N, Alghamdi D, Almahmoudi A, et al.. Risk factors of acute kidney injury in children with diabetic ketoacidosis. BMC Nephrol. 2025, 26:254. 10.1186\/s12882-025-04178-0","journal-title":"BMC Nephrol"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00805","article-title":"A systematic review of childhood diabetes research in the Middle East region","volume":"10","author":"Saraswathi S","year":"2019","unstructured":"Saraswathi S, Al-Khawaga S, Elkum N, Hussain K. A systematic review of childhood diabetes research in the Middle East region. Front Endocrinol (Lausanne). 2019, 10:805. 10.3389\/fendo.2019.00805","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2009.00600.x","article-title":"Ketoacidosis at presentation of type 1 diabetes in children in Kuwait: frequency and clinical characteristics","volume":"11","author":"Abdul-Rasoul M","year":"2010","unstructured":"Abdul-Rasoul M, Al-Mahdi M, Al-Qattan H, et al.. Ketoacidosis at presentation of type 1 diabetes in children in Kuwait: frequency and clinical characteristics. Pediatr Diabetes. 2010, 11:351-6. 10.1111\/j.1399-5448.2009.00600.x","journal-title":"Pediatr Diabetes"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61112066","article-title":"Prevalence, clinical, and immunological features of familial type 1 diabetes among children and adolescents: a retrospective study from Saudi Arabia","volume":"61","author":"Abutaleb R","year":"2025","unstructured":"Abutaleb R, Yafei S, Hummadi A, et al.. Prevalence, clinical, and immunological features of familial type 1 diabetes among children and adolescents: a retrospective study from Saudi Arabia. Medicina (Kaunas). 2025, 61:2066. 10.3390\/medicina61112066","journal-title":"Medicina (Kaunas)"},{"key":"ref14","article-title":"How to establish and expand an intensive care unit in a low- and middle-income country","author":"Shimber ET","year":"2023","unstructured":"Shimber ET. How to establish and expand an intensive care unit in a low- and middle-income country. Global Surgery. Hardy MA, Hochman BR (ed): Springer, Cham; 2023."},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13296","article-title":"Alarming increase in ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes during the first wave of the COVID-19 pandemic in Israel","volume":"23","author":"Goldman S","year":"2022","unstructured":"Goldman S, Pinhas-Hamiel O, Weinberg A, et al.. Alarming increase in ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes during the first wave of the COVID-19 pandemic in Israel. Pediatr Diabetes. 2022, 23:10-18. 10.1111\/pedi.13296","journal-title":"Pediatr Diabetes"},{"key":"ref16","article-title":"Frequency and clinical characteristics of ketoacidosis at onset of childhood type 1 diabetes mellitus in Northwest Saudi Arabia","volume":"26","author":"Habib HS","year":"2005","unstructured":"Habib HS. Frequency and clinical characteristics of ketoacidosis at onset of childhood type 1 diabetes mellitus in Northwest Saudi Arabia. Saudi Med J. 2005, 26:1936-9.","journal-title":"Saudi Med J"},{"key":"ref17","doi-asserted-by":"crossref","DOI":"10.4236\/jdm.2017.72004","article-title":"Clinical Demographic Patterns of Type 1 Diabetes in Saudi Children in Tabuk City, 2000-2010","volume":"7","author":"Albishi LA","year":"2017","unstructured":"Albishi LA, Altoonisi MM, Alblewi SM, et al.. Clinical Demographic Patterns of Type 1 Diabetes in Saudi Children in Tabuk City, 2000-2010. J Diabetes Mellitus. 2017, 7:41-54.","journal-title":"J Diabetes Mellitus"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al.. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021, 372:n71. 10.1136\/bmj.n71","journal-title":"BMJ"},{"key":"ref19","article-title":"Interrater reliability: the kappa statistic","volume":"22","author":"McHugh ML","year":"2012","unstructured":"McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012, 22:276-82.","journal-title":"Biochem Med (Zagreb)"},{"key":"ref20","unstructured":"Wells G, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute. (2000). https.\/\/ohri.ca\/en\/who-we-are\/core-facilities-and-platforms\/ottawa-methods-centre\/newcastle-ottawa-scale."},{"key":"ref21","article-title":"Systematic reviews of etiology and risk (Chapter 7)","author":"Moola S","year":"2017","unstructured":"Moola S, Munn Z, Tufanaru C, et al.. Systematic reviews of etiology and risk (Chapter 7). JBI Reviewer's Manual. Aromataris E, Munn Z (ed): 2017."},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.11.014","article-title":"Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement","volume":"65","author":"Hoy D","year":"2012","unstructured":"Hoy D, Brooks P, Woolf A, et al.. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012, 65:934-9. 10.1016\/j.jclinepi.2011.11.014","journal-title":"J Clin Epidemiol"},{"key":"ref23","unstructured":"R. A language and environment for statistical computing. (2025). https:\/\/www.R-project.org\/."},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-203104","article-title":"Meta-analysis of prevalence","volume":"66","author":"Barendregt JJ","year":"2013","unstructured":"Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013, 66:746-8. 10.1136\/jech-2013-203104","journal-title":"J Epidemiol Community Health"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-25","article-title":"The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method","volume":"14","author":"IntHout J","year":"2014","unstructured":"IntHout J, Ioannidis JP, Borm GF. The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method. BMC Med Res Methodol. 2014, 14:25. 10.1186\/1471-2288-14-25","journal-title":"BMC Med Res Methodol"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010247","article-title":"Plea for routinely presenting prediction intervals in meta-analysis","volume":"6","author":"IntHout J","year":"2016","unstructured":"IntHout J, Ioannidis JP, Rovers MM, Goeman JJ. Plea for routinely presenting prediction intervals in meta-analysis. BMJ Open. 2016, 6:e010247. 10.1136\/bmjopen-2015-010247","journal-title":"BMJ Open"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins JP","year":"2003","unstructured":"Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003, 327:557-60. 10.1136\/bmj.327.7414.557","journal-title":"BMJ"},{"key":"ref28","article-title":"Operating characteristics of a rank correlation test for publication bias","volume":"50","author":"Begg CB","year":"1994","unstructured":"Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994, 50:1088-101.","journal-title":"Biometrics"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt GH","year":"2008","unstructured":"Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Sch\u00fcnemann HJ. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008, 336:924-6. 10.1136\/bmj.39489.470347.AD","journal-title":"BMJ"},{"key":"ref30","article-title":"Diabetic ketoacidosis in children admitted to Pediatric Intensive Care Unit of King Fahad Hospital, Al-Baha, Saudi Arabia: precipitating factors, epidemiological parameters and clinical presentation","volume":"13","author":"Satti SA","year":"2013","unstructured":"Satti SA, Saadeldin IY, Dammas AS. Diabetic ketoacidosis in children admitted to Pediatric Intensive Care Unit of King Fahad Hospital, Al-Baha, Saudi Arabia: precipitating factors, epidemiological parameters and clinical presentation. Sudan J Paediatr. 2013, 13:24-30.","journal-title":"Sudan J Paediatr"},{"key":"ref31","doi-asserted-by":"crossref","DOI":"10.31014\/aior.1994.07.01.301","article-title":"Prevalence, clinical profile, and outcomes of diabetic ketoacidosis in pediatric patients at the intensive care unit of King Fahad Hospital, Al-Baha, Saudi Arabia","volume":"7","author":"Almawazini A","year":"2024","unstructured":"Almawazini A, Taha SA, Abdullah AA, Soliman AF, Mohammed M, Alghamdi AA, Alghamdi MO. Prevalence, clinical profile, and outcomes of diabetic ketoacidosis in pediatric patients at the intensive care unit of King Fahad Hospital, Al-Baha, Saudi Arabia. Journal of Health and Medical Sciences. 2024, 7:25-9.","journal-title":"Journal of Health and Medical Sciences"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000042453","article-title":"Effects of insulin infusion volume on diabetic ketoacidosis outcome in pediatrics: retrospective observational study","volume":"104","author":"Al Muqati H","year":"2025","unstructured":"Al Muqati H, Alsmari A, Alrahili M, AlJuraibah F, Aldibasi O, Alsaleh NA. Effects of insulin infusion volume on diabetic ketoacidosis outcome in pediatrics: retrospective observational study. Medicine (Baltimore). 2025, 104:e42453. 10.1097\/MD.0000000000042453","journal-title":"Medicine (Baltimore)"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13370","article-title":"Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: a prospective study","volume":"23","author":"Hegab AM","year":"2022","unstructured":"Hegab AM, Khalil FF, Abosedera MM. Incidence and factors associated with acute kidney injury among children with type 1 diabetes hospitalized with diabetic ketoacidosis: a prospective study. Pediatr Diabetes. 2022, 23:783-91. 10.1111\/pedi.13370","journal-title":"Pediatr Diabetes"},{"key":"ref34","article-title":"Clinical and biochemical profile of pediatric diabetic ketoacidosis patients in Al-Zahraa hospital pediatric ICU","volume":"73","author":"Mohammed RA","year":"2018","unstructured":"Mohammed RA, Abdalla NA, Mahran FA. Clinical and biochemical profile of pediatric diabetic ketoacidosis patients in Al-Zahraa hospital pediatric ICU. Egypt J Hosp Med. 2018, 73:7507-11.","journal-title":"Egypt J Hosp Med"},{"key":"ref35","article-title":"Diabetic ketoacidosis: demographic data, clinical profile and outcome in a tertiary care hospital","volume":"27","author":"Razavi Z","year":"2017","unstructured":"Razavi Z, Hamidi F. Diabetic ketoacidosis: demographic data, clinical profile and outcome in a tertiary care hospital. Inn J Pediatr. 2017, 27:e7649.","journal-title":"Inn J Pediatr"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/463275-prevalence-clinical-profile-and-outcomes-of-diabetic-ketoacidosis-dka-in-pediatric-icu-patients-in-the-middle-east-a-systematic-review-and-meta-analysis","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T20:16:28Z","timestamp":1771272988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/463275-prevalence-clinical-profile-and-outcomes-of-diabetic-ketoacidosis-dka-in-pediatric-icu-patients-in-the-middle-east-a-systematic-review-and-meta-analysis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":35,"URL":"https:\/\/doi.org\/10.7759\/cureus.103735","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,16]]}}}