Diabetic Ketoacidosis at Diagnosis in Austrian Children: A Population-Based Analysis, 1989-2011

Fritsch, Maria; Schober, Edith; Rami-Merhar, Birgit; Hofer, Sabine E.; Fröhlich‐Reiterer, Elke; Waldhoer, Thomas

doi:10.1016/j.jpeds.2013.06.033

Cited by 67 publications

(99 citation statements)

References 20 publications

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“…The non-significant decrease in the proportion of presentations in DKA in our patient population is also similar to the worldwide trends [22]. While decrease in DKA rates have been noted in some countries [22][23][24] many developed countries continue to report high rates [25][26][27]. Factors like degree of awareness of symptoms of diabetes among parents and primary care physicians have been proposed to affect the risk of developing DKA at diagnosis [27] but targeted intervention with a community-based information program, generally considered successful in preventing ketoacidosis [28], failed to decrease the rates of DKA in one study [25].…”

Section: Discussionsupporting

confidence: 82%

Hospital based incidence, patterns of presentation and outcome of type 1 diabetes: 12 years’ data from a tertiary care center in North India

Dayal

Saini

Jayashree

et al. 2015

Int J Diabetes Dev Ctries

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Increase in the incidence of Type 1 diabetes (T1D) over last several decades has been reported worldwide. There is a dearth of data on incidence/prevalence of T1D in children from India. We studied the trends in incidence of T1D amongst children attending a tertiary care pediatric hospital of North India over last 12 years and the changes in incidence, patterns of presentation and disease outcomes during this period by retrospective analysis of patient records and hospital census data. The study population comprised of 647 children with onset of T1D below 16 years who attended the hospital from April, 2001 to March, 2013. There was a consistent increase in the total number of T1D patients every year. The increase in the proportion of younger (<5 years) patients (16.2 % in 2001-02 versus 35.2 % in 2012-13) was significantly more as compared to other age categories. The percentage of patients who presented with DKA decreased every year (65 % in 2001-02 to 36.3 % in 2012-13). Younger (<5 years) patients were two to three times more likely to present in DKA than older (>15 years) patients (mean yearly percentage 60.3 versus 25 %). The proportion of patients presenting during winter months was almost double than the average of any of the 3 seasons (39 versus 20.3 %). The overall mortality was 1.7 %. In conclusion, the number of patients with T1D has shown an increase although the severity of presentation has declined. Marked seasonality in presentation indicates some unidentified environmental factors triggering the onset of disease in our patient population.

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Section: Discussionsupporting

confidence: 82%

Hospital based incidence, patterns of presentation and outcome of type 1 diabetes: 12 years’ data from a tertiary care center in North India

Dayal

Saini

Jayashree

et al. 2015

Int J Diabetes Dev Ctries

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“…A study of Austrian indicated that the incidence of DKA was negatively correlated with age [5]. Klingensmith and colleagues have reported that younger age, lack of private health insurance, and African American ancestral heritage are independent risk factors for DKA [6].…”

Section: Discussionmentioning

confidence: 99%

Breath Ketone Testing: A New Biomarker for Diagnosis and Therapeutic Monitoring of Diabetic Ketosis

Qiao

Gao

Liu

et al. 2014

BioMed Research International

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Background. Acetone, β-hydroxybutyric acid, and acetoacetic acid are three types of ketone body that may be found in the breath, blood, and urine. Detecting altered concentrations of ketones in the breath, blood, and urine is crucial for the diagnosis and treatment of diabetic ketosis. The aim of this study was to evaluate the advantages of different detection methods for ketones, and to establish whether detection of the concentration of ketones in the breath is an effective and practical technique. Methods. We measured the concentrations of acetone in the breath using gas chromatography-mass spectrometry and β-hydroxybutyrate in fingertip blood collected from 99 patients with diabetes assigned to groups 1 (−), 2 (±), 3 (+), 4 (++), or 5 (+++) according to urinary ketone concentrations. Results. There were strong relationships between fasting blood glucose, age, and diabetic ketosis. Exhaled acetone concentration significantly correlated with concentrations of fasting blood glucose, ketones in the blood and urine, LDL-C, creatinine, and blood urea nitrogen. Conclusions. Breath testing for ketones has a high sensitivity and specificity and appears to be a noninvasive, convenient, and repeatable method for the diagnosis and therapeutic monitoring of diabetic ketosis.

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“…In Austria for example, the risk of DKA on a prospectively recorded country-wide register remained similar between 2005 to 2009 and 2010 to 2011. 27 A single-center study from Australia found no change in the risk of DKA in 1073 children and adolescents ages up to 18 years with newly diagnosed T1DM from 1998 to 2010. 28 Similarly, in Auckland, the largest city in New Zealand, the incidence and severity of new-onset DKA remained stable at approximately 27% over the past 15 years 29 and are similar to the previous review in 1995 to 1996.…”

Section: Diabetic Ketoacidosis At Diagnosismentioning

confidence: 98%

“…27 This study attempted greater penetration than other studies, and posters were given to all kindergartens, schools, pharmacies, pediatricians, and general practitioners in 2009. In addition, medical officers in schools received education twice a year, and there was national media publicity.…”

Section: Protective Factorsmentioning

confidence: 99%

Preventing Diabetic Ketoacidosis

Jefferies

Nakhla

Derraik

et al. 2015

Pediatric Clinics of North America

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Diabetic Ketoacidosis at Diagnosis in Austrian Children: A Population-Based Analysis, 1989-2011

Cited by 67 publications

References 20 publications

Hospital based incidence, patterns of presentation and outcome of type 1 diabetes: 12 years’ data from a tertiary care center in North India

Hospital based incidence, patterns of presentation and outcome of type 1 diabetes: 12 years’ data from a tertiary care center in North India

Breath Ketone Testing: A New Biomarker for Diagnosis and Therapeutic Monitoring of Diabetic Ketosis

Preventing Diabetic Ketoacidosis

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