Ketoacidosis at onset of type 1 diabetes mellitus in children - frequency and clinical presentation

Abstract

The proportion of DKA in children with newly diagnosed diabetes mellitus is significant. In particular, children < 5 yr and girls face an increased risk. DKA may be the result of a particularly aggressive subtype of diabetes.

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

“…The observed prevalence was distinctly higher than the recently published DKA rates in northern Finland [6] and southern Sweden [4,8], but similar to those reported for Germany [15], the UK [16] and the USA [7].…”

“…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.…”

Cuadro clínico de inicio de la diabetes tipo 1 en el niño

“…Se consideró que el paciente presentaba cetoacidosis cuando el pH era igual o menor de 7,3, el bicarbonato menor de 15,0 mmol/l y había cetonas en plasma 11,12 .…”

“…Neu et al 12 , en una evaluación de 10 años en el estado alemán de Baden-Württemberg, pesquisaron 2.121 niños que debutaron con DM1. En ellos, describieron una incidencia de cetoacidosis (glicemia mayor de 250 m/dl, pH <7,3, bicarbonato <15 mmol y cetonuria) variable entre 20% y 31%.…”

“…La misma observación ha sido descrita por Neu et al 12 . En este último grupo, la dosis de insulina requerida al alta fue menor.…”