Subscribe to RSS

DOI: 10.1055/s-0043-1772453
Knowledge and Confidence of Omani Pediatric Residents in Managing Diabetic Ketoacidosis: A Cross-Sectional Survey
Funding and Sponsorship None.

Abstract
Introduction Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus. Unfortunately, medical errors are not uncommon during the management of DKA leading to significant morbidity and mortality. There are many studies conducted to assess the knowledge of junior doctors in the management of DKA in many countries including Bahrain and Iraq.
Objectives This study aims to assess the knowledge and confidence of Omani pediatric residents in the management of DKA and compare the findings with the results of previous studies from the region.
Materials and Methods A cross-sectional study was conducted among all enrolled pediatric residents in the Oman Medical Specialties Board in 2021, using an online survey that consists of three parts with a total of 30 questions to gain information about demographics, knowledge, and overall confidence in the management of DKA in children. The questionnaire was adopted from the Bahraini and Iraqi studies.
Results In total, 69 pediatric residents (15M:54F) out of 84 had responded to the survey, giving a response rate of 82%. More than half of the responders were junior residents R1 and R2 (59.3%). The overall performance score of knowledge among the residents mainly ranged between 50 and 75%. However, R2 resident performance was better as their score ranged between 80 and 85%. Only 5.7% of our residents had a performance score above 90%. The overall confidence of residents in managing patients with DKA was directly proportional to their year of residency, ranging from not confident to very confident, demonstrating that most residents from R1 to R3 rated themselves as “fair” compared with 58.3% of 4th-year residents who rated themselves as confident. In comparison to similar studies in Bahrain and Iraq, our junior residents showed better knowledge in some aspects, for example, identifying the correct biochemical criteria to diagnose DKA, 88.7 vs. 65% from Bahrain and 20.7% from Iraq.
Conclusion The overall knowledge and confidence of the Omani pediatric residents were satisfying. However, there are still some gaps in knowledge to be bridged about the management of pediatric DKA. Continuous educational activities are desired. Therefore, more sessions about DKA management are to be scheduled, perhaps applying some simulation training to boost their knowledge and confidence.
Keywords
type one diabetes mellitus - diabetic ketoacidosis - pediatric residents - knowledge - residents - training - educationCompliance with Ethical Principles
The study was approved by the ethical committee of OMSB. Informed consent was provided by participants.
Authors' Contribution
H.A. conceptualized the idea of this research. M.A. collected and analyzed the data. M.A. drafted the manuscript and H.A. reviewed it. Both authors agreed on the final version.
Publication History
Article published online:
18 September 2023
© 2023. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Royal College of Paediatrics and Child Health. 2020. State of Child Health. London: RCPCH; Accessed July 19, 2023 at: https://stateofchildhealth.rcpch.ac.uk/evidence/long-term-conditions/diabetes/
- 2 Paschou SA, Papadopoulou-Marketou N, Chrousos GP, Kanaka-Gantenbein C. On type 1 diabetes mellitus pathogenesis. Endocr Connect 2018; 7 (01) R38-R46
- 3 Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect 2020; 10 (02) 98-115
- 4 International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021. Accessed July 19, 2023 at: https://www.diabetesatlas.org
- 5 Huang Y, Karuranga S, Malanda B, Williams D. The IDF diabetes atlas 9th edition. In: Diabetes Research and Clinical Practice. 2019. 140. 144-145
- 6 Gallagher E, Siu HY. Diabetic ketoacidosis as first presentation of type 1 diabetes mellitus in a young child: important differential diagnosis for respiratory distress. Can Fam Physician 2020; 66 (06) 425-426
- 7 Shaltout AA, Channanath AM, Thanaraj TA. et al. Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait. Sci Rep 2016; 6: 27519
- 8 Ahmed AM, Al-Maghamsi M, Al-Harbi AM, Eid IM, Baghdadi HH, Habeb AM. Reduced frequency and severity of ketoacidosis at diagnosis of childhood type 1 diabetes in Northwest Saudi Arabia. J Pediatr Endocrinol Metab 2016; 29 (03) 259-264
- 9 Al-Yaarubi S, Ullah I, Sharef SW. et al. Demographic and clinical characteristics of type 1 diabetes mellitus in Omani children—single center experience. Oman Med J 2014; 29 (02) 119-122
- 10 Zayed H. Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a systematic review. Int J Clin Pract 2016; 70 (03) 186-195
- 11 González Pannia P, Balboa R, Navarro R, Nocita MF, Ferraro M, Mannucci C. Prevalence of cerebral edema among diabetic ketoacidosis patients. Arch Argent Pediatr 2020; 118 (05) 332-336
- 12 Hallett A. MBChB FRCA and others, Developments in the management of diabetic ketoacidosis in adults: implications for anaesthetists. BJA Educ 2016; 16 (01) 8-14
- 13 Akcan N, Uysalol M, Kandemir I. et al. Evaluation of the efficacy and safety of 3 different management protocols in pediatric diabetic ketoacidosis. Pediatr Emerg Care 2021; 37 (11) e707-e712
- 14 Glaser NS, Kuppermann N, Yee CK, Schwartz DL, Styne DM. Variation in the management of pediatric diabetic ketoacidosis by specialty training. Arch Pediatr Adolesc Med 1997; 151 (11) 1125-1132
- 15 Ali K, Ali MF, Alsaffar H. The knowledge and confidence in management of diabetic ketoacidosis (DKA) among Bahraini pediatric residents: a cross-sectional survey. Ann Rom Soc Cell Biol 2021; 25 (04) 9840-9851
- 16 Abdullah WH, Aljumaili AH, Alsaffar H. Knowledge and confidence of Iraqi pediatric residents in management of diabetic ketoacidosis in children. Med-Leg Update 2022; 22 (02) 140-148
- 17 Heddy N. Guideline for the management of children and young people under the age of 18 years with diabetic ketoacidosis (British Society for Paediatric Endocrinology and diabetes). Arch Dis Child Educ Pract Ed 2021; 106 (04) 220-222
- 18 Glaser N, Fritsch M, Priyambada L. et al. ISPAD clinical practice consensus guidelines 2022: diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes 2022; 23 (07) 835-856
- 19 Savage MW, Dhatariya KK, Kilvert A. et al; Joint British Diabetes Societies. Joint British Diabetes Societies guideline for the management of diabetic ketoacidosis. Diabet Med 2011; 28 (05) 508-515