Diabetic ketoacidosis in Asian children

Alvi, N S; Davies, Patricia A.; Kirk, Jeremy; Shaw, Nicholas

doi:10.1136/adc.85.1.60

Cited by 33 publications

(17 citation statements)

References 6 publications

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“…The overall incidence of DKA at diagnosis was 27.2%, which was similar to that found in other studies 2. The incidence of DKA at presentation was higher in ethnic minorities (41.3%) than in children from a white background (21.4%), which concurs with earlier findings from our unit4 showing that 48% of Asian children with newly diagnosed T1DM presented with DKA. Van Laar et al 5 have shown that non-Western immigrant children were likely to be sicker at first presentation with T1DM when compared to Dutch children, suggesting a delay in diagnosis.…”

Section: Discussionsupporting

confidence: 91%

Delayed diagnosis in type 1 diabetes mellitus

Sundaram

Day

Kirk

2008

Archives of Disease in Childhood

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Children with suspected type 1 diabetes mellitus (T1DM) should have same day referral to a paediatric diabetes team. 99 children (54 male; median age 10.5 years, range 0.9-15.9 years) were diagnosed with T1DM at our hospital between January 2004 and June 2007. 27 (27.2%) presented in diabetic ketoacidosis (DKA). 37 (37.3%) required hospital admission, while the rest had ambulatory management. In 21 (21.2%) children, diagnosis was delayed >24 h (median 3.0 days, range 1-14 days) due to missed diagnosis at the local hospital (four) or by the general practitioner (seven), arranging a fasting blood glucose test (nine) and outpatient appointment requested via fax (one). Children with delayed diagnosis presented more frequently in DKA (52.3% vs 20.5%, p<0.01), with a higher median presenting HbA1c (12.3% vs 10.9%, p<0.05). There were no differences in age and sex between the delayed diagnosis and immediate referral groups. Healthcare providers need to be aware of the importance of immediate referral of children newly diagnosed with T1DM.

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Section: Discussionsupporting

confidence: 91%

Delayed diagnosis in type 1 diabetes mellitus

Sundaram

Day

Kirk

2008

Archives of Disease in Childhood

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“…Alvi showed that young Asian children in Birmingham had an eightfold increased risk of presenting with DKA as did non-Asian children. 17 In a study by Habib, 55.3% and Al Magamsi 55.2% of diabetic children presented with ketoacidosis at diagnosis in Saudia Arabia. 18.19 Similarly, 65% of the 304 patients in Taiwan and 49% of newly diagnosed diabetic children in Kuwait presented with diabetic ketoacidosis.…”

Section: Discussionmentioning

confidence: 97%

Frequency of Ketoacidosis in Newly Diagnosed Type 1 Diabetic Children

Razavi

2010

OMJ

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“…6 Poor glycemic control, family and school problems, low socioeconomic status, ethnicity, sex, and lack of adequate health insurance have been reported to increase risk of acute complications in children with type 1 diabetes. 9,19,24 However, these predictors have not been sufficiently characterized to allow for effective preventive programs. 25 The purpose of this study was to determine the incidence and the predictors of DKA and severe hypoglycemia in a large contemporary cohort of children with type 1 diabetes.…”

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confidence: 99%