Severity at onset of childhood type 1 diabetes in countries with high and low incidence of the condition

Sadauskait≐-Kuehne, V; Samuelsson, Ulf; Jašinskien, E; Padaiga, Žilvinas; Urbonait, B; Edenvall, H; Ludvigsson, Johnny

doi:10.1016/s0168-8227(01)00328-x

Cited by 56 publications

(55 citation statements)

References 36 publications

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“…The observed prevalence was distinctly higher than the recently published DKA rates in northern Finland [6] and southern Sweden [4,8], but similar to those reported for Germany [15], the UK [16] and the USA [7].…”

Section: Discussionsupporting

confidence: 85%

“…A shortcoming of our investigation is that the registry contained no data on socioeconomic factors such as family income or parental educational level or on ethnicity on an individual basis, which have been described as factors predisposing to the development of DKA [7,8,15,[20][21][22]. We found an interesting regional difference among Austrian provinces, with the highest risk in Tyrol and Vienna.…”

Section: Discussionmentioning

confidence: 86%

“…The prevalence of onset DKA varies widely among studies, but most studies have been hospital-based and might therefore have been influenced by the selection bias of hospital referral [2,4,6]. There is substantial variation in the incidence rate of type 1 diabetes in children below 15 years in Europe and the regional incidence rate of type 1 diabetes has been reported to be inversely correlated with the prevalence of DKA at diagnosis [1,8].…”

Section: Introductionmentioning

confidence: 99%

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Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

2010

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Aim The aim of the study was to analyse the prevalence of diabetic onset ketoacidosis (DKA) during a period of 20 years (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)) on a population basis in the whole of Austria. Methods A prospective population-based incidence study (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) was performed. The registered data set comprised blood glucose, pH, ketonuria and clinical symptoms of DKA at manifestation. DKA was defined as pH<7.3 and severe DKA as pH<7.1. Time trends were estimated using linear regression models. Results During the study period, 3331 children <15 years of age (1,797 boys and 1,534 girls) were registered with newly diagnosed type 1 diabetes. Of these, 1,238 (37.2%) presented with DKA, 855 (25.7%) had a mild and 383 (11.5%) a severe form, and one patient died at onset. DKA frequency was negatively associated with age at onset (p< 0.0001). In children <2 years the prevalence was 60%, with a higher risk for girls (70% vs 54% for boys, p<0.05). Despite a significant increase in diabetes incidence in Austria during the observation period from 8.4 to 18.4/ 100,000 (p<0.0001), no significant change in the prevalence of DKA at manifestation was observed. Conclusions The overall frequency of DKA in children with newly diagnosed type 1 diabetes in Austria is high and has not changed during the last 20 years despite a clear increase in the manifestation rate. In particular, children less than 2 years of age have a high risk of DKA at onset.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

2010

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“…A valid comparison of studies is, however, difficult because of the variable definitions of DKA used. Furthermore, there is substantial variation in the incidence of type 1 diabetes between different populations (4), and an inverse correlation between the frequency of DKA and the background incidence of type 1 diabetes has been reported (5,6).…”

mentioning

confidence: 99%

Ketoacidosis at Diagnosis of Type 1 Diabetes in Children in Northern Finland

2007

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“…Estudos indicam que osmolaridade plasmática superior a 330 mOsm/kg é associada a torpor e coma. Sua medida pode ser feita com osmômetro ou através da seguinte fórmula: 2 (Na + + K + ) + glicemia (em mg/dl)/18 + uréia (em mg/dl)/6 (Normal: 285-295 mOsm/kg) Cálculo do anion GAP O anion gap (soma dos cátions diminuída da soma dos ânions) é aumentado na CAD e pode ser calculado através da seguinte fórmula: Na + -(Cl -+ HCO 3 -) (Normal: 7-9) (48,49) A diminuição do anion gap ao longo do tratamento, com persistência da acidose, pode indicar acidose hiperclorêmica (por sobrecarga de cloreto administrado com a solução salina a 0,9%).…”

Section: Osmolaridade Plasmáticaunclassified

Cetoacidose diabética em adultos: atualização de uma complicação antiga

Barone

Rodacki

Cenci

et al. 2007

Arq Bras Endocrinol Metab

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RESUMOA cetoacidose diabética é uma complicação aguda do Diabetes Mellitus (DM) caracterizada por hiperglicemia, acidose metabólica, desidratação e cetose, na vigência de deficiência profunda de insulina. Acomete principalmente pacientes com DM tipo 1 e geralmente é precipitada por condições infecciosas, uso inadequado de insulina ou desconhecimento do diagnóstico de diabetes. Os autores revisam mecanismos fisiopatológicos, critérios diagnósticos e opções terapêuticas do distúrbio em adultos, bem como suas possíveis complicações. ACETOACIDOSE DIABÉTICA (CAD) é uma complicação aguda do Diabetes Mellitus (DM) caracterizada por hiperglicemia, acidose metabólica, desidratação e cetose, na vigência de deficiência profunda de insulina. Acomete principalmente pacientes com DM tipo 1 (DM1) e geralmente é precipitada por condições infecciosas ou omissão da administração de insulina. Por vezes, a CAD pode ser a forma de apresentação clínica inicial do DM1 ou mesmo do tipo 2 (DM2). A CAD é observada ao diagnóstico de DM1 em 3 a 40% dos pacientes diagnosticados com DM1 (1-4). Recentemente, identificamos que, em nossa população, essa freqüência é de 32,8% (5).Estima-se que a CAD tenha uma incidência anual de cerca de 1 a 5% da população, sem alterações significativas nos últimos anos (2). Existe uma incidência de CAD discretamente maior no sexo feminino, principalmente entre os adolescentes (6). No Brasil, existem poucos dados nacionais de incidência dessa complicação aguda (7-9).Se diagnosticada e tratada de forma rápida e correta, a CAD tem bom prognóstico, sendo prontamente revertida na maioria das vezes (10). A mor-

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Severity at onset of childhood type 1 diabetes in countries with high and low incidence of the condition

Cited by 56 publications

References 36 publications

Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

Ketoacidosis at Diagnosis of Type 1 Diabetes in Children in Northern Finland

Cetoacidose diabética em adultos: atualização de uma complicação antiga

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