Characteristics of admissions with diabetic ketoacidosis in a specialized children hospital: Missing insulin is still a challenge!

Abstract

Aim: To assess the characteristics of admissions with diabetic ketoacidosis (DKA) in a specialized children hospital in order to inform appropriate prevention and intervention strategies. Methods: This is a retrospective chart review of DKA admissions of children with T1DM at King Abdullah Specialized Children's hospital, Riyadh, Saudi Arabia (March 2015-December 2017). Results: A total of 116/562 patients with type 1 diabetes (mean age 8.97±3.08 years, Females n=81 (55.5%)) presented with DKA during the study period. The majority were between 10-14 years of age (p=<0.001). We scrutinized data from (146/311, 47%) DKA events of all inpatient admissions of children with T1D. The frequency of DKA admissions was 26% (n=146/562 of all patients with T1DM, 25% (n= 42/141) were in newly diagnosed and 24.7% (n=104/421) were in previously diagnosed patients). Missing insulin was the main precipitating cause (p=0.001) in previously diagnosed patients. Recurrent episodes (n=30, 20.5% of all episodes) occurred in 15/116 patients and was more common in children ?10 years old (P=0.024). The overall mean length of