Is diabetic ketoacidosis a good predictor of 5-year metabolic control in children with newly diagnosed type 1 diabetes?

Abstract

Background The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up. Methods The study included children treated due to newly diagnosed T1D complicated with DKA between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA1C, total daily insulin dose, basal insulin and BMI-SDS. Results 85 children at the median age of 7.93 years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA1C level (7,3%vs7,2%;p = .413) were noted after 5 years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA1C. The method of insulin delivery at baseline was significantly associated with HbA1C levels after 5 years of observation, βCSII = − 1.46,95%CI[− 2.01 to − 0.92],p < .001. Conclusions The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA1C improvement.

The Relationship Between Long-Term Glycemic Control and Partial Remission in Type 1 Diabetes: A Retrospective Study

“…However, it could be speculated that an experience of a severe presentation of T1D at diagnosis may have led to more careful and vigilant management of the disease by patients and their families. Additionally, several studies could not find a difference in long-term prognosis between the DKA and non-DKA groups (44,45).…”

Diabetic Ketoacidosis Complications in Pediatrics: A Narrative Review

“…Diabetes mellitus (DM) is a metabolic disorder affecting blood glucose levels. It has two main types: type I is characterized by reduced or absent insulin release from pancreatic beta cells, and type II is characterized by reduced insulin sensitivity from body tissues [1,2].…”