Increased incidence and severity of diabetic ketoacidosis among uninsured children with newly diagnosed type 1 diabetes mellitus

Maniatis, Aristides K; Goehrig, Stephanie H.; Gao, Dexiang; Rewers, Arleta; Walravens, P.; Klingensmith, Georgeanna J.

doi:10.1111/j.1399-543x.2005.00096.x

Cited by 60 publications

(50 citation statements)

References 13 publications

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“…A shortcoming of our investigation is that the registry contained no data on socioeconomic factors such as family income or parental educational level or on ethnicity on an individual basis, which have been described as factors predisposing to the development of DKA [7,8,15,[20][21][22]. We found an interesting regional difference among Austrian provinces, with the highest risk in Tyrol and Vienna.…”

Section: Discussionmentioning

confidence: 86%

Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

2010

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Aim The aim of the study was to analyse the prevalence of diabetic onset ketoacidosis (DKA) during a period of 20 years (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)) on a population basis in the whole of Austria. Methods A prospective population-based incidence study (1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) was performed. The registered data set comprised blood glucose, pH, ketonuria and clinical symptoms of DKA at manifestation. DKA was defined as pH<7.3 and severe DKA as pH<7.1. Time trends were estimated using linear regression models. Results During the study period, 3331 children <15 years of age (1,797 boys and 1,534 girls) were registered with newly diagnosed type 1 diabetes. Of these, 1,238 (37.2%) presented with DKA, 855 (25.7%) had a mild and 383 (11.5%) a severe form, and one patient died at onset. DKA frequency was negatively associated with age at onset (p< 0.0001). In children <2 years the prevalence was 60%, with a higher risk for girls (70% vs 54% for boys, p<0.05). Despite a significant increase in diabetes incidence in Austria during the observation period from 8.4 to 18.4/ 100,000 (p<0.0001), no significant change in the prevalence of DKA at manifestation was observed. Conclusions The overall frequency of DKA in children with newly diagnosed type 1 diabetes in Austria is high and has not changed during the last 20 years despite a clear increase in the manifestation rate. In particular, children less than 2 years of age have a high risk of DKA at onset.

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Section: Discussionmentioning

confidence: 86%

Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

2010

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“…Chronically ill children may be particularly vulnerable. Newly diagnosed uninsured diabetic children are more likely to present with more severe diabetic ketoacidosis [45]. However, among children with asthma who experienced gaps in Tennessee Medicaid coverage, there were no increases in asthma-related emergency department visits or hospitalization during periods of un-insurance [46 • ].…”

Section: Specific Diagnoses/diseasesmentioning

confidence: 99%

Being uninsured: impact on children??s healthcare and health

Fry-Johnson

Daniels²,

Levine³

et al. 2005

Current Opinion in Pediatrics

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“…Tüm yaş gruplarında halen yüksek oranda rapor edilmekle birlikte, özellikle küçük yaş grubunun tanı ve tedavi gecikmesi nedeni ile daha yüksek oranda görülmektedir (5)(6)(7)(8). Bunun yanında, düşük sosyoekonomik durum, ailede diyabet öyküsünün olmaması ve T1DM prevalansının düşük olması (farkındalığın az olması) da DKA tablosu ile başvuru için risk faktörleri arasında gösterilmektedir (9,10).…”

Section: Introductionunclassified

Changes in the Frequency of Diabetic Ketoacidosis in Type I Diabetes Mellitus Cases at Diagnosis: A Fifteen-Year Single Center Experience

Acar¹,

Gören²,

Paketçi³

et al. 2017

jpr

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. The symptom duration was significantly lower and DKA frequency was higher in ≤5 year-old patients (p<0.001, p<0.004, respectively). The most prevalent symptoms were polyuria, polydipsia, and weight loss. The patients were diagnosed mostly (61.5%) in autumn and winter. Conclusion: This study showed that the frequency of DKA among children with newly diagnosed T1DM in our country is still high. This indicates a persistent need to increase awareness of the symptoms of diabetes.

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Increased incidence and severity of diabetic ketoacidosis among uninsured children with newly diagnosed type 1 diabetes mellitus

Cited by 60 publications

References 13 publications

Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis

Being uninsured: impact on children??s healthcare and health

Changes in the Frequency of Diabetic Ketoacidosis in Type I Diabetes Mellitus Cases at Diagnosis: A Fifteen-Year Single Center Experience

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