Incidence of diabetic ketoacidosis in newly diagnosed type 1 diabetes children in western Saudi Arabia: 11-year experience

Abstract

Background A wide range of reports on the incidence of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in children have been published worldwide. Reports from Saudi Arabia are limited. The aim of this study was to assess the incidence, clinical pattern and severity of DKA in children with newly diagnosed T1DM and the association of autoimmune conditions with initial DKA occurrence at King Abdulaziz Medical City – Jeddah. Methods This retrospective chart review was conducted during the period 2005–2015. All newly diagnosed T1DM children during the study period were investigated (n = 390). Data were collected on the demographic characteristics, body mass index (BMI), DKA severity, length of hospital stay and follow-up data on the type of diabetes therapy. Results The incidence of DKA among newly diagnosed T1DM pediatric patients was 37.7% (n = 147). Moderate and severe DKA cases were significantly higher among female children (p = 0.04). Patients diagnosed with DKA had lower BMI (20.87 ± 5.21) than their counterparts (p = 0.03). The median length of hospital stay was higher among severe DKA compared to moderate and mild cases (5.0, 4.5 and 4.0 days, respectively). Conclusions The incidence of DKA among newly diagnosed T1DM is still high compared to developed countries; however, it is relatively lower than previous reports in Saudi Arabia. Immediate interventions, such as awareness campaigns, are vital to reduce the burden of this preventable health sequela among children with DM.

Increased frequency of severe diabetic ketoacidosis at type 1 diabetes onset among children during COVID-19 pandemic lockdown: an observational cohort study

“…Literature suggests that increased awareness of T1D results in earlier diagnosis and treatment, can lead to DKA rate decrease [8,[33][34][35]. However, awareness publicity campaigns directed to type 1 diabetes have not shown consistent results [24,33,34,[36][37][38][39].…”

Awareness of Parents Regarding DKA Symptoms in their Children with Type I DM

“…Hence, hyperglycemic crisis and development of DKA can be prevented by good education about diabetes, for both the patient and parents [11,12] DKA incidence at King Abdulaziz Medical City -Jeddah. They have found that the incidence of DKA among those who are newly diagnosed as T1DM pediatric patients was 37.8%, which is a high percentage [13].…”

Enteroviruses and Type 1 Diabetes Mellitus: An Overlooked Relationship in Some Regions

“…Different cities in Saudi Arabia have reported that there is a significant increase in the incidence and prevalence of T1DM in the last 20 years [ 28 , 29 ]. A systematic review in 2017 reported that the number of children with T1DM is 16,100.…”

“…Moreover, this rate of incidence was more likely linked to environmental factors, particularly viral infections, rather than genetic factors. Hence, the authors recommended conducting further epidemiological studies to screen environmental triggers, especially viral infections [ 29 , 30 ]. However, an earlier report in the Eastern region of Saudi Arabia found that there was no relationship between the etiology of T1DM and viral infections, despite the previously noted seasonal pattern of T1DM [ 31 ].…”