Ethnicity and young age influence the frequency of diabetic ketoacidosis at the onset of type 1 diabetes

Rodacki, Melanie; Pereira, Joana Rodrigues Dantas; Oliveira, Aline Moreira Nabuco de; Barone, Bianca; Dowell, Renata Mac; Perricelli, Paula; Bravo, Michelle; Oliveira, Marcus Miranda de; Brum, Júlia Dias; Belém, Luciana Camara; Ornellas, Phelipe Guimarães de; Berardo, Renata Szundy; Luescher, Jorge Luiz; Campos, L.P.; Vangelotti, Andrea de Menezes; Kupfer, Rosane; Zajdenverg, Lenita; Milech, Adolpho; Oliveira, José Egídio Paulo de

doi:10.1016/j.diabres.2007.04.002

Cited by 46 publications

(36 citation statements)

References 11 publications

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“…Our data show no association between age and severity of DKA. The data confirm the results of other studies indicating that age was not significantly associated with the severity of DKA (28)(29)(30). In contrast Jesic et al (31) reported that severe DKA was more frequent in the age group < 5 years.…”

Section: Discussionsupporting

confidence: 83%

Diabetic Ketoacidosis: Demographic Data, Clinical Profile and Outcome in a Tertiary Care Hospital

Razavi

Hamidi

2017

Iran J Pediatr

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Background: Diabetic ketoacidosis (DKA) is an acute and life-threatening situation that accounts for the majority of diabetesrelated morbidity and mortality in children and adolescents who suffer from type 1 diabetes mellitus (T1DM). Objectives: To investigate the demographic, clinical characteristics, and outcomes of DKA in young patients with established T1DM and newly diagnosed diabetes in a tertiary referral hospital. Methods: Data from all T1DM patients diagnosed with DKA episodes in the pediatric endocrine unit at Besat university hospital, Hameden, Iran during 2006 -2013 were reviewed in a retrospective study. The data collected includes the demographic data (age, sex, place of residence, first presentation and established T1DM), clinical presentation (main presenting symptoms, average duration of presenting symptoms before hospitalization, precipitating factors, severity of DKA, level of consciousness), laboratory parameters (blood sugar, arterial blood gases, urine ketones, serum electrolytes) and the outcome. DKA was defined as a glucose level higher than 250 mg/dL, pH < 7.30, bicarbonate > 15 mmol/L and ketonuria. Data was entered and analyzed on SPSS version 16. A P value less than 0.05 were defined as statistically significant. Results: The study population comprised 72 children satisfying the inclusion criteria of the study. Mean age of patients was 9.4

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Section: Discussionsupporting

confidence: 83%

Diabetic Ketoacidosis: Demographic Data, Clinical Profile and Outcome in a Tertiary Care Hospital

Razavi

Hamidi

2017

Iran J Pediatr

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“…The observed frequency of DKA in our population is in line with countries geographically near Denmark. A higher DKA rate was observed in the youngest age group (<5 years), which is consistent with previous studies undertaken in countries with a high incidence of type 1 diabetes [4,10,14,16,29]. The very young children (<2 years) had an undesirably high prevalence of DKA (48.3%), comparable with register studies from Sweden, Finland and Germany (39.5-54.9%) [15,30,31].…”

Section: Discussionsupporting

confidence: 80%

Diabetic ketoacidosis at the onset of type 1 diabetes is associated with future HbA1c levels

et al. 2013

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Aims/hypothesis We investigated the long-term impact of diabetic ketoacidosis (DKA) at onset on metabolic regulation and residual beta cell function in a Danish population with type 1 diabetes. Methods The study is based on data from DanDiabKids, a Danish national diabetes register for children. The register provides clinical and biochemical data on patients with type 1 diabetes diagnosed in 1996-2009 and then followed-up until 1 January 2012. Repeated-measurement models were used as statistical methods.Results The study population comprised 2,964 children <18 years. The prevalence of DKA at diagnosis was 17.9%. Of the total subjects, 8.3% had mild, 7.9% had moderate and 1.7% had severe DKA. DKA (moderate and severe) was associated with increased HbA 1c (%) levels (0.24; 95% CI 0.11, 0.36; p=0.0003) and increased insulin dose-adjusted HbA 1c (IDAA 1c , 0.51; 95% CI 0.31, 0.70; p<0.0001) during followup, after adjustment for covariates. Children without a family history of diabetes were more likely to present with DKA (19.2% vs 8.8%, p<0.0001); however, these children had a lower HbA 1c (%) level over time (−0.35; 95% CI −0.46, −0.24; p<0.0001). Continuous subcutaneous insulin infusion (CSII) was associated with a long-term reduction in HbA 1c , changing the effect of DKA, after adjustment for covariates (p<0.0001). Conclusions/interpretation DKA at diagnosis was associated with poor long-term metabolic regulation and residual beta cell function as assessed by HbA 1c and IDAA 1c, respectively; however, CSII treatment was associated with improvement in glycaemic regulation and residual beta cell function, changing the effect of DKA at onset in our population.

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“…4 In Europe and North America, this figure ranged from approximately 15 to 70%. [5][6][7][8][9] It remains unknown why some children present in DKA and whether the development of diabetic ketoacidosis is a consequence of delayed diagnosis and treatment or whether it reflects a particularly aggressive form of diabetes. 10 In our study, 39.7% and 37.9% of patients suffered from moderate and severe DKA, respectively.…”

Section: Discussionmentioning

confidence: 99%

Diabetic ketoacidosis in children: an 11-year retrospective in Surabaya, Indonesia

Rochmah

Faizi

Harjantien

2015

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Ethnicity and young age influence the frequency of diabetic ketoacidosis at the onset of type 1 diabetes

Cited by 46 publications

References 11 publications

Diabetic Ketoacidosis: Demographic Data, Clinical Profile and Outcome in a Tertiary Care Hospital

Diabetic Ketoacidosis: Demographic Data, Clinical Profile and Outcome in a Tertiary Care Hospital

Diabetic ketoacidosis at the onset of type 1 diabetes is associated with future HbA1c levels

Diabetic ketoacidosis in children: an 11-year retrospective in Surabaya, Indonesia

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