Chemotherapy Induced Diabetic Ketoacidosis in a child

Varadarajan, Poovazhagi; Thangavelu, S.; Shanthi, S

doi:10.7199/ped.oncall.2012.30

Cited by 1 publication

(2 citation statements)

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“…Importantly, this rise appears to not be due to changes in overall glycaemic control [25] but instead seems to be related to an increase in recurrent DKA events in young adults and/or in those living in areas of higher deprivation. Such findings agree with that presented elsewhere that recurrent DKA associates with emerging adulthood [5,7,22], and this is mainly due to a higher overall HbA1c, reduced access to healthcare, and adherence to insulin treatment [7,22,26]. Unfortunately, psychosocial screening is not routine for admissions to hospital in New Zealand, though this could provide further insight into these DKA admissions, given the higher rates of low mood and disordered eating in young adults and adolescents with diabetes (particularly T1D) [27].…”

Section: Discussionsupporting

confidence: 94%

“…DKA may be the first presentation of previously unknown diabetes mellitus or may be a nonrecurrent or recurrent event in those with established diabetes mellitus due to either omission of insulin and/or intercurrent stressors [3]. Although DKA is largely preventable, it is the leading cause of mortality in children with T1D and is associated with long-term sequelae, including cognitive and renal impairment in both children and adults [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Diabetic Ketoacidosis in the Waikato Region of New Zealand: 2000-2019

Chepulis,

Papa,

Lao

et al. 2023

Journal of Diabetes Research

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Aims. Diabetic ketoacidosis (DKA) is not well characterised in New Zealand. This study is aimed at characterising the change in epidemiology and severity of DKA from 2000 to 2019 at a tertiary hospital in the Waikato region of New Zealand. Methods. A retrospective clinical data review of all patients admitted to Waikato District Health Board hospitals with DKA was undertaken. Characteristics and severity of DKA were assessed by type of DKA admission (diagnosed at admission, nonrecurrent, and recurrent), ethnicity, social deprivation, intensive care unit (ICU) admission, and length of hospital stay, with linear regression reporting on changes over time. Results. There were 1254 admissions for DKA (564 individual patients), two-thirds being recurrent events. Nonrecurrent DKA patients were younger, whilst recurrent admissions for DKA were associated with T1D, female gender, greater socioeconomic deprivation, and rural living (all P values < 0.01). DKA admission increased 8-fold between 2000 and 2019, mostly due to an increased number of recurrent events, particularly in Māori and female patients ( P < 0.001 ). ICU admissions increased over time ( P < 0.001 ) whilst length of hospital stay trended down ( P = 0.031 ). Conclusions. The rise in recurrent DKA is concerning, particularly in youth and indigenous Māori. Healthcare inequities need to be addressed, including adequate access to mental health support to ensure optimal outcomes for all patients with diabetes.

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