Background: Diabetic keto acidosis (DKA) is a serious metabolic disorder among children with new onset Type 1 Diabetes mellitus and is associated with high morbidity and mortality. Objective of the present study was to assess the risk factors associated with mortality in DKA at its initial presentation among children with new onset type 1 diabetes mellitus (T1DM).Methods: A case control study was designed and conducted in the Institute of child Health and Hospital for children, Madras Medical College, Chennai from February 2013 to February 2015. All children admitted with DKA as initial presentation of type 1 Diabetes mellitus were enrolled for this study.Results: Out of 72 new cases of T1DM, diagnosed during the study period 47 children had DKA and 25 children presented without DKA. Of the 47 children 6 children died. On comparing risk factors for mortality in DKA at the initial presentation, delayed treatment(p-0.002), altered sensorium at presentation(p-0.04), high urea(p-0.014) creatinine(p-0.042), lower bicarbonates (p-0.035), higher sodium(p-0.025) and lower pH(p-0.009) were found to be significantly associated with mortality. Overall mortality in DKA at its initial presentation is 12.8%.Conclusions: Delay in therapy for DKA and presence of features of severe disease at admission are significant risk factors for mortality.

Background: Diabetic keto acidosis (DKA) is a serious complication of pediatric diabetic patients, which leads to increased morbidity and mortality in children. Objective of the present study was to assess the risk factors associated of DKA for initial presentation among pediatric type 1 diabetes mellitus (T1DM) patients and its poor outcome.Methods: A case control study was designed and conducted at the Institute of Child Health and Hospital for children, Madras Medical College, Chennai from February 2013 to February 2015. All children admitted with new onset T1DM either with or without DKA were enrolled for this study.Results: Out of 72 cases of T1DM, 47 children with DKA were considered as cases and 25 children without DKA were considered as controls. On comparing both the groups Age, gender, place of residence, BMI were similar .Major risk factors for presentation as DKA were lack of family history of diabetes, shorter duration of illness and delayed diagnosis in the form of higher number of medical visits prior to DKA diagnosis. Six among 47 DKA died while none in control group died.Conclusions: Short duration of illness and missing the diagnosis was significantly associated with initial presentation as DKA among children with Type 1 diabetes.