High Frequency of Diabetic Ketoacidosis in Children with Newly Diagnosed Type 1 Diabetes

Abstract

Aim. The aim of this study was to evaluate the incidence of diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in 2006-2007 and 2013-2014. Method. The study group consisted of 426 children aged 0–18 years with type 1 diabetes onset admitted to our hospital in 2006-2007 (group A) and 2013-2014 (group B). The study comprised the analysis of medical and laboratory records from patients' medical charts and the electronic database. Results. There was no difference between groups A and B in the percentage of children admitted with diabetic ketoacidosis (25% versus 28%, resp., P = 0.499). Among children with diabetic ketoacidosis, severe metabolic decompensation (pH < 7.1) appeared in similar frequency in groups A and B (28% versus 30%, resp., P = 0.110). In group B, children with diabetic ketoacidosis were statistically younger compared to patients without ketoacidosis (P = 0.015) and had higher HbA1c levels (P = 0.006). In both groups, a 2-fold increase in diabetic ketoacidosis was noted in children under the age of 3, compared to overall frequency. Conclusion. No decrease in diabetic ketoacidosis has been noted in the recent years. Although the prevalence and severity of diabetic ketoacidosis remain stable, they are unacceptably high. The youngest children are especially prone to ketoacidosis.

Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east gojjam zone referral hospitals north west Ethiopia, 2019.

“…This discrepancy might be due to methodological differences, in those two studies the incidence was calculated based on newly diagnosed DM, but in the current study, the incidence was estimated based on known diabetes diagnosed children. This nding is much higher than studies done in the US which was 25.5% [22] , 40.3% in Italy [23] , 27% in New Zealand [24] in Poland 28% [25] , 40% in southern Iraq [26] . This discrepancy might be due to methodological differences, in the US the incidence was calculated based on newly diagnosed DM, in others the incidence was calculated based on both newly diagnosed DM and known diabetes children but in the current study, the incidence was estimated based on known Diabetes.…”

Insulin therapy is not associated with improved clinical outcomes in critically ill infants with stress hyperglycemia

“…Studies with larger samples may help to clarify this issue. Ketoacidosis generally occurs in children aged <5 years with type I diabetes and low levels of effective insulin action (29,33). In the present study, no evidence of this condition was indicated, even in patients who received no insulin therapy.…”

Incidence and predictors of diabetic ketoacidosis among children with diabetes in west and east gojjam zone referral hospitals north west Ethiopia, 2019.

“…However, this nding is much higher than studies done in the US which was 25.5% [21], 40.3% in Italy [22], 27% in New Zealand [23], 28% in Poland [24], 40% in southern Iraq [25]. This discrepancy might be due to differences in methodology, lifestyle, culture, economical status, access to health care facilities, and level of education of the general public.…”