Changes in the Frequency of Diabetic Ketoacidosis in Type I Diabetes Mellitus Cases at Diagnosis: A Fifteen-Year Single Center Experience

Acar, Sezer; Gören, Yıldız; Paketçi, Ahu; Anık, Ahmet; Çatlı, Gönül; Tuhan, Hale; Demır, Kadir; Böber, Ece; Abacı, Ayhan

doi:10.4274/jpr.16768

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…A multicenter study from Europe was showed newly diagnosed DKA patients had symptoms at least two weeks (12). Articles from Turkey also reported that period before DKA diagnosis was usually two weeks (7,10,13). In our study, we reached our study populations admission time was same as other reports in literature.…”

Section: Resultssupporting

confidence: 66%

Eski ve Yeni Tanı Pediatrik Diyabetik Ketoasidoz Hastalarının Klinik Farklılıkların Değerlendirilmesi

Özcan

AKAY

BOZKURT

et al. 2022

Türkiye Çocuk Hast Derg

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Amaç: Amacımız, çocuk yoğun bakım ünitesinde diyabetik ketoasidoz (DKA) ile takip edilen daha önce tanı almış ve yeni tanı almış Tip 1 Diabetes Mellitus (T1DM) hastalarının şiddeti, klinik özellikleri, komplikasyon varlığı ve sonuç farklılıklarını belirlemektir. Gereç ve Yöntemler: Bu çalışma, 32 yataklı üçüncü basamak çocuk yoğun bakım ünitesinde geriye dönük olarak yapıldı. Hastalar yeni tanı almış ve önceden tanı almış T1DM olarak ayrıldı. Toplanan tüm veriler gruplar arasında karşılaştırıldı. Bulgular: 107 hasta çalışmaya dahil edildi. Hastaların çoğu erkekti (%51.4). Yeni tanı alan hastaların çoğu 6-10 yaş grubundaydı (%49.2). Başvuru öncesi hasta şikâyetleri değerlendirildiğinde kusma şikayeti, daha önce tanı almış DM hastalarında istatistiksel olarak anlamlı derecede yüksekti (p=0.041). Yeni tanı alan Tip-1 DM’de halsizlik, poliüri, polidipsi, kilo kaybı şikâyetleri istatistiksel olarak anlamlı derecede yüksekti (p değeri sırasıyla 0.001, 0.001, 0.001, 0.001). Diyabetik ketoasidoz tedavisi sırasında yeni tanı almış DM grubunda hipokalemi istatistiksel olarak daha yüksekti (p=0.015). Yoğun bakım süreleri arasında fark olmamasına rağmen yeni tanı konmuş DM hastalarında toplam yatış günleri istatistiksel olarak daha uzundu (p değerleri sırasıyla 0.145, 0.007). Hastalarda mortalite görülmedi. Sonuç: Okul yaş grubu, yeni tanı konan T1DM’de en sık görülen yaş grubuydu. Yeni tanı Diyabetik Ketoasidoz hastalarında poliüri, polidipsi, kilo kaybı sık iken; eski tanılı diyabetik ketoasidoz hastalarında kusma yaygın olarak saptandı. Hastalar ve ailelerin bu semptomlar ve hastalık hakkında bilgi düzeyini artırıcı eğitimler, ulusal reklamlar vb uygulamalar yapılmalıdır.

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Section: Resultssupporting

confidence: 66%

Eski ve Yeni Tanı Pediatrik Diyabetik Ketoasidoz Hastalarının Klinik Farklılıkların Değerlendirilmesi

Özcan

AKAY

BOZKURT

et al. 2022

Türkiye Çocuk Hast Derg

View full text Add to dashboard Cite

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“…The severity of DKA at presentation has been previously investigated. Acar et al 27 found severe DKA in 22.1%, moderate in 32.8% and mild in 45.1% at the time of first presentation. In a study from Germany 30 , the majority of these cases (63.8%) had no ketoacidosis, while 16.6% had mild, 12.1% moderate, and 4% severe ketoacidosis at the time of diagnosis.…”

Section: Discussionmentioning

confidence: 95%

“…Ardicli et al 14 reported the frequency of diagnosis with DKA to be 50.5% between 1990-2000 and 51.0% between 2000-2010. Acar et al 27 found the incidence of DKA to be 43.2% in patients with a new diagnosis of T1DM between 1999 and 2014. In our cohort the overall rate of DKA presentation was 46.6%, which is consistent with earlier Turkish reports.…”

Section: Discussionmentioning

confidence: 99%

Trend in initial presenting features of type 1 diabetes mellitus over a 24 year period in Turkey: a retrospective analysis of 814 cases

Dündar¹,

Akıncı²,

Çamtosun³

et al. 2022

Turk J Pediatr

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Background. The study aim was to examine changes in trends of presenting features during the diagnosis of patients followed up with newly diagnosed Type 1 diabetes mellitus (T1DM) over the past 24 years. Methods.The study was retrospective. Patients with a diagnosis of T1D between the years of 1996-2019 were included. Patients diagnosed in the first half of the period comprised Period I, and those from the second half comprised Period II. Patient data were extracted from medical records and included gender distribution, year of diagnosis, age at diagnosis, duration of symptoms, type of admission, frequency of diabetic ketoacidosis (DKA) and biochemical parameters. Subsequently, temporal changes in trends of these parameters were sought.Results. For the whole cohort the gender distribution was equal; 404 (49.6%) were girls and 410 (50.4%) were boys. Mean age at diagnosis was 8.5±4.2 years and age groupings at presentation were: 23.2% (n = 189) aged 0-4; 39.2% (n = 319) aged 5-9; 27.5% (n = 224) aged 10-13; 10.1% (n= 82) aged 14-18. At presentation 72 (12.7%) had hyperglycemia, 230 (40.6%) had diabetic ketosis, and 264 (46.6%) had DKA. In those with DKA, mild DKA was found in 103 (39.0%), moderate DKA in 81 (30.6%), and severe DKA in 80 (30.3%). While the frequency of DKA was 54.9% between 1996 and 2007 (Period I), this significantly decreased to 44.4% between 2008 and 2019 (Period II). Girls and boys had a similar rate of T1DM, and this did not change over time. Three peak ages of diagnosis were evident; 5-7, 8-10, 12-14 years of age.Conclusions. The frequency of DKA decreased and the frequency of admission with hyperglycemia and ketosis increased during the study period, which may have repercussions for mortality and morbidity rates and aid in improved treatment outcomes.

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“…Acar et al 17 reported that severe ketoacidosis has been reported to be 10%, over a period of 5 years in Turkey. Severe DKA rate was 23.2% (13/56) in all new-onset T1D cases in our study.…”

Section: Discussionmentioning

confidence: 99%

The Examination of the Relationship Between COVID-19 and New-Onset Type 1 Diabetes Mellitus in Children

Donbaloğlu

Tuhan

Kara

et al. 2022

Turk Arch Pediatrics

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Objective This study aimed to evaluate presentations of new-onset type 1 diabetes mellitus in a pediatric cohort during the coronavirus disease 2019 pandemic. Materials and Methods: This study was designed as a single-center, descriptive, cross-sectional retrospective study. The patients diagnosed with new-onset type 1 diabetes mellitus between April 1, 2020, and April 1, 2021, were included in the study. The rate of severe acute respiratory syndrome coronavirus 2 polymerase chain reactivity-positivity was investigated. The pandemic period was compared with the same period of the pre-pandemic 2 years in terms of number of new-onset type 1 diabetes mellitus patients, rate of presentation with diabetic ketoacidosis, and degree of diabetic ketoacidosis severity. Results: In total, 56 patients were diagnosed with type 1 diabetes mellitus during the pandemic and 2 (3.57%) of them tested positive for severe acute respiratory syndrome coronavirus 2 polymerase chain reaction. The number of new-onset type 1 diabetes mellitus patients was 39 in 2019 and 39 in 2018. The rate of presentation with diabetic ketoacidosis was similar in the pandemic period compared to the pre-pandemic periods (53.5% in 2020 vs. 56.4% in 2019 and 53.8% in 2018; P = .94). The proportion of severe diabetic ketoacidosis was also similar in all years, respectively (43.3% in 2020 vs. 45.4% in 2019 and 47.6% in 2018; P = .95). Conclusion: We reported only 2 cases that tested positive for severe acute respiratory syndrome coronavirus 2among the new-onset type 1 diabetes mellitus patients during the pandemic. Although we found an increase in the number of new-onset type 1 diabetes mellitus cases by comparing with prepandemic period, rates of diabetic ketoacidosis and severe diabetic ketoacidosis were similar. There was no finding to suggest that severe acute respiratory syndrome coronavirus 2taking a part in type 1 diabetes mellitus pathogenesis. Since the development of type 1 diabetes mellitus is a long process, prospective studies are needed to investigate the long-term effects of severe acute respiratory syndrome coronavirus 2.

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Changes in the Frequency of Diabetic Ketoacidosis in Type I Diabetes Mellitus Cases at Diagnosis: A Fifteen-Year Single Center Experience

Cited by 4 publications

References 14 publications

Eski ve Yeni Tanı Pediatrik Diyabetik Ketoasidoz Hastalarının Klinik Farklılıkların Değerlendirilmesi

Eski ve Yeni Tanı Pediatrik Diyabetik Ketoasidoz Hastalarının Klinik Farklılıkların Değerlendirilmesi

Trend in initial presenting features of type 1 diabetes mellitus over a 24 year period in Turkey: a retrospective analysis of 814 cases

The Examination of the Relationship Between COVID-19 and New-Onset Type 1 Diabetes Mellitus in Children

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