First report on the nationwide incidence of type 1 diabetes and ketoacidosis at onset in children in Serbia: a multicenter study

Vuković, Rade; Jesic, Maja; Vorgucin, Ivana; Stanković, S; Folić, Nevena; Milenković, Tatjana; Sajic, Silvija; Katanic, Dragan; Živić, Saša; Markovic, Slavica; Soldatović, Ivan

doi:10.1007/s00431-018-3172-4

Cited by 20 publications

(16 citation statements)

References 25 publications

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“…Only 68% of centres reported adoption of the ISPAD guidelines to manage DKA, and there was great variation in the approach to management 1. These data were consistent with a comprehensive study of DKA incidence during a 10-year follow-up in Italy by Cherubini et al ,2 and with studies published in the same period in other European3–5 and Extra European countries 6 7…”

Section: Introductionsupporting

confidence: 71%

Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0–18 years

et al. 2019

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ObjectiveAfter a previous survey on the incidence of diabetic ketoacidosis (DKA) at onset of type 1 diabetes in children in 2013–2014 in Italy, we aimed to verify a possible decline in the incidence of DKA at onset during a national prevention campaign.DesignProspective observational study.SettingMulticentre study throughout Italy.InterventionNational awareness campaign started in November 2015 and held until December 2017.PatientsDuring 2016 and 2017 we collected data on all patients aged 0–18 years with new-onset diabetes.Main outcome measuresDKA (pH <7.30), severe DKA (pH <7.1), DKA in children below 6 years and DKA treatment according to the Italian Society for Pediatric Endocrinology and Diabetology (ISPED) protocol were evaluated.ResultsRecords (n=2361) of children with newly diagnosed type 1 diabetes were collected from 58 out of 68 (85.3%) centres of the original survey participants and 100% of the previously surveyed tertiary centres. Overall, DKA was observed in 1124 patients, with an increased rate when compared with the previous survey (47.6% vs 38.5%, p=0.002), and severe DKA in 15.3%. In children below 6 years, DKA was observed in 323 out of 617 (52.5%) and severe DKA in 16.7%; in this age group, occurrence of DKA reduced by 21.3% (p=0.009). DKA treatment according to the ISPED guidelines was adopted in 95% of the centres, with a 27% improvement (p=0.025).ConclusionsDuring a 2-year awareness campaign, DKA at onset of diabetes in children and adolescents 0–18 years is still common and increased when compared with the 2013–2014 survey.

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Section: Introductionsupporting

confidence: 71%

Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0–18 years

et al. 2019

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“…The Poisson regression resulted that younger children (0–4 years old) are significant more affected of ketoacidosis than older children. Similar results were found in a study of type 1 diabetes among Serbian children Vukovic et al [29].…”

Section: Discussionsupporting

confidence: 91%

Ketoacidosis at onset of type 1 diabetes in children up to 14 years of age and the changes over a period of 18 years in Saxony, Eastern-Germany: A population based register study

et al. 2019

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Objective The aim of this study was to examine the incidence trends of type 1 diabetes diagnosed with ketoacidosis in Saxony, Germany from 1999 to 2016. Methods The population based Childhood Diabetes Registry of Saxony comprising valid data for all children aged 0–14 years diagnosed with type 1 diabetes from1999 to 2016 were used for the analyses. Direct age-standardized incidence rates were calculated and the effects of age, sex, calendar year, home districts and family history of any types of diabetes on the incidence were modelled using Poisson regression. Trend analyses for standard rate ratios of children with moderate and severe diabetic ketoacidosis versus children with type 1 diabetes with non-diabetic ketoacidosis were performed using join point regression. Results The rate of ketoacidosis at the time of the type 1 diabetes diagnosis was high with 35.2% during the entire observation period in Saxony. The Poisson regression analysis indicated a statistically significant increased occurrence of diabetic ketoacidosis for younger age-groups, but no statistically significant differences between boys and girls. The join point trend analyses show that the proportion of severe and moderate ketoacidosis is increasing disproportionally to the increase in incidence of type 1 diabetes over the years. Conclusion Due to the observed increasing incidence of diabetes as well of diabetic ketoacidosis, an educational prevention campaign is needed in Saxony as soon as possible to aid pediatricians, general physicians as well as general public to identify the early signs of type 1 diabetes.

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“…15,16 However, high frequency of DKA among children with T1DM was reported in countries such as Egypt, Serbia, Saudi Arabia, USA, UK and others. [17][18][19][20][21][22][23][24] The current study showed a trend of increase in the severity of DKA among children with T1DM over the study period with an overall frequency of 12.3%. This frequency is comparable to that reported in Kuwait, Spain, France, Finland and Italy.…”

Section: Discussionmentioning

confidence: 87%

Frequency and severity of ketoacidosis at diagnosis among childhood type 1 diabetes in Khartoum state, Sudan

Ahmed¹,

Khabour²,

Ahmed³

et al. 2020

Afr H. Sci.

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Background: Diabetic ketoacidosis (DKA) is a potentially life threatening acute complication of Type I diabetes mellitus (T1DM). This study aimed to determine the frequency and clinical characteristics of pediatric DKA at diagnosis of new-onset T1DM in Khartoum during 2000- 2017 period. Methods: The study was retrospective and involved review of medical files of children (<15 years) with T1DM in the city hos- pitals and diabetes centers. Results: The overall frequency of DKA among T1DM children at onset of disease diagnosis was 17.6% (173/982). The epi- sodes of DKA increased from 26% in first 6- year period (2000-2005) to 46.3% in the last 6-year period (2011-2012; p<0.001). No significant difference in the frequency of DKA was observed according to gender (p=0.9) and age (p=0.24). Compared to other age groups, the severity of DKA (pH<7.1) was higher in pre-school children (p<0.01). Approximately, 5% of patients were complicated with cerebral edema with a mortality rate of 1.7%. Conclusion: The DKA frequency at diagnosis of childhood T1DM in Khartoum was lower than previous reports. In addition, the severity of DKA was high among pre-school age children with a relatively high mortality rate when compared to the global rate. Keywords: Ketoacidosis; mortality; onset; DKA; T1DM; Sudan; Khartoum.

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First report on the nationwide incidence of type 1 diabetes and ketoacidosis at onset in children in Serbia: a multicenter study

Cited by 20 publications

References 25 publications

Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0–18 years

Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0–18 years

Ketoacidosis at onset of type 1 diabetes in children up to 14 years of age and the changes over a period of 18 years in Saxony, Eastern-Germany: A population based register study

Frequency and severity of ketoacidosis at diagnosis among childhood type 1 diabetes in Khartoum state, Sudan

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