Diabetic ketoacidosis (DKA) is the most serious complication in newly diagnosed cases of type 1 diabetes. We have determined the frequency of DKA at diagnosis in children with type 1 diabetes in Lagos University Teaching Hospital over a 10-year period, and have compared rates for the earlier and later years of the study period. This was a retrospective review of the case records of all the patients diagnosed with type 1 diabetes over a 10-year period from 2005 to 2015. Fiftysix (56) patients (26 males; 30 females), were seen with a mean age at diagnosis of 9.7±3.9 years. Thirty-one (31) patients (55%) presented with DKA at diagnosis. The mean age at diagnosis of the patients with DKA (8.7±3.4) was lower that of the patients without DKA (11.0±4.0, p=0.021). The median duration of symptoms before presentation in the DKA group was lower than the non-DKA group (three vs four weeks, p=0.002). Patients aged 5.0–10.9 years constituted more than half (58%) of the patients presenting with DKA. The younger age group has a greater tendency to present with DKA (p=0.004). The rate of DKA was higher in the Yoruba than the Ibo ethnic groups (p=0.007). The frequency of DKA at diagnosis in the latter years (47.4%) reduced by a quarter from the rate of 72% in the earlier years (p=0.076). We conclude that the rate of DKA at diagnosis is still unacceptably high, although has shown a slight reduction in more recent years.

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