Daniel Oyedemi1, Micheal Abimbola Oladosu2, Moses Adondua Abah3, Elizabeth Okeoghene Alagba4 and Bukola Oluwaseyi Olufosoye5

 1Emergency Medicine Department, Warrington and Halton Teaching Hospitals, United Kingdom.

2Department of Chemical Sciences, Faculty of Science, Anchor University, Lagos, Nigeria.

3Department of Biochemistry, Faculty of Pure and Applied Sciences, Federal University of Wukari, Wukari, Taraba State, Nigeria

4Department of Biology Technical Education, Faculty of Education Federal University of Technology, Minna, Nigeria

5Department of Medical Microbiology, Faculty of Medical Laboratory Sciences.

Ambrose Alli University, Ekpoma, Edo State, Nigeria

() Corresponding Author

Received: Apr 30, 2026/ Revised: May 29 2026/Accepted: June 4, 2026 

Highlights

  • Reviews lifestyle-related determinants contributing to diabetic ketoacidosis (DKA).
  • Examines the roles of e-cigarette use, alcohol intake, and recreational drug exposure.
  • Explores epidemiological trends and biological mechanisms linking substance use to DKA.
  • Highlights emerging DKA risks among adolescents and young adults with diabetes.
  • Emphasizes targeted prevention, risk stratification, and public health interventions.

Abstract

Diabetic ketoacidosis (DKA) represents a severe metabolic complication of diabetes mellitus with significant morbidity and mortality implications. While traditional risk factors such as insulin non-compliance and infection are well-established, emerging evidence suggests that lifestyle behaviours, particularly e-cigarette use, alcohol consumption, and recreational drug exposure, play increasingly important roles in DKA pathogenesis. This comprehensive review synthesises current epidemiological evidence on the relationships between these lifestyle determinants and the occurrence, severity, and outcomes of DKA. Recent studies demonstrate that e-cigarette use, especially among youth and young adults, contributes to metabolic derangements through oxidative stress, inflammatory responses, and direct pancreatic beta-cell toxicity. Alcohol consumption exhibits a complex dose-dependent relationship with DKA risk, where both acute intoxication and chronic use patterns influence metabolic control. Recreational drugs, including cannabis, cocaine, and synthetic cannabinoids, have emerged as significant DKA precipitants through multiple mechanisms including appetite suppression, insulin omission, and direct metabolic effects. This review presents epidemiological trends, mechanistic insights, and public health implications of these lifestyle factors. Understanding these relationships is crucial for developing targeted prevention strategies, improving risk stratification, and informing public health policies addressing the intersection of substance use and diabetes management.

Keywords: Diabetic ketoacidosis; E-cigarettes; Vaping; Alcohol consumption; Recreational drugs; Cannabis; Lifestyle factors; Public health; Epidemiology; Diabetes complications

How to cite this article

Oyedemi, D., Oladosu, M. A., Adondua Abah, M., Alagba, E. O., & Olufosoye, B. O. (2026). Lifestyle-related determinants of diabetic ketoacidosis: Epidemiological and public health insights into e-cigarette use, alcohol intake, and recreational drug exposure: Review article. Science Archives, 7(2), 114–123. https://doi.org/10.47587/SA.2026.7210

This work is licensed under a Creative Commons Attribution 4.0 International License

 

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