dawnmedDawnMed Journal of Medical ScienceISVolume 2, Issue 4MultidisciplinaryEnglish2026NNY2026111PediatricsParental Awareness of and Response to Symptoms of Hypoglycemia and Diabetic Ketoacidosis in Children with Type 1 Diabetes in Tabuk, Saudi Arabia: A Cross-Sectional StudyEnglishY8189Abdalla AliAbdalla¹*EnglishNHyderMirghani²EnglishYLamia FaisalAlbalawi³EnglishYJomana NasserAlkhraisi³EnglishYNorah Saud BinMubrad³EnglishYAlhanouf AbdullahBedaiwi³EnglishYLaila MohammedAlfaidi³EnglishYMohamed-Ameen AbdallaAli⁴EnglishYNouf AwadAlanazi⁵EnglishYBackground: Children with type 1 diabetes (T1D) rely on their parents to recognize and treat hypoglycemia and diabetic ketoacidosis (DKA). We assessed parents’ knowledge of both conditions, their intended responses, and the factors associated with adequate knowledge in Tabuk, Saudi Arabia.Methods:In this cross-sectional study, parents of children younger than 18 years with T1D in Tabuk completed an online Arabic questionnaire between May and October 2025. Recognition of symptoms and precipitating factors was scored (maximum 8 for hypoglycemia and 12 for DKA), and a score of at least 50% of the maximum was classed as adequate. Associated factors were examined with multivariable logistic regression.Results:Of 383 responses, 376 were analyzed. Adequate knowledge was found in 52.1% of parents for hypoglycemia and 43.6% for DKA. Sweating was the most recognized hypoglycemia symptom (64.9%) and convulsions the least (27.7%); exercise was the least recognized trigger (27.9%). For hypoglycemia, 77.7% would give a sugary drink and 58.2% would check blood glucose. Polyuria was the most recognized DKA symptom (64.9%), and acetone breath and shortness of breath the least (34.8% each). For suspected DKA, 68.4% would take the child to hospital, 42.3% would check blood glucose and 30.3% would give insulin. Four daily insulin injections (vs two) were associated with adequate knowledge of hypoglycemia (adjusted odds ratio 4.27, 95% confidence interval 2.19–8.33) and of DKA (3.71, 1.97–6.97). Non-Saudi families had lower knowledge; after adjustment, this was statistically significant only for the continuous hypoglycemia score.Conclusions:About half of the parents had inadequate knowledge, particularly of severe hypoglycemia and late DKA signs, and fewer than one-third would give insulin for suspected DKA. 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