Abstract Objective To investigate the incidence of diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes. Methods A retrospective analysis was performed for the clinical data of 224 children with newly diagnosed type 1 diabetes, and according to the presence or absence of DKA, these children were divided into DKA group and non-DKA group, with 112 children in each group. The DKA group was further divided into ≥ 5-year group (65 children) and < 5-year group (47 children), and according to the blood gas parameters, this group was divided into mild group (26 children), moderate group (29 children), and severe group (57 children). The factors influencing the development of DKA were analyzed, as well as the clinical and laboratory features of DKA children with different ages. Results The most common symptoms in these 224 children with type 1 diabetes were polydipsia (86.2%), polyuria (78.6%), and weight loss (57.1%). Compared with the non-DKA group, the DKA group had a significantly higher percentage of children who were aged <5 years, who had low family income, or whose parents had an educational level of senior high school or below. The DKA group had significantly higher levels of random blood glucose and HbA1C and significantly lower levels of pH, HCO3-, and C-peptide than the non-DKA group (P < 0.05). There was no significant difference in the percentage of children with severe DKA between the ≥ 5-year group and the < 5-year group (P > 0.05). Compared with the < 5-year group, the ≥ 5-year group sufferred from symptoms for a significantly prolonged period, and had a significantly lower level of random blood glucose and significantly higher levels of HbA1C and C-peptide (P < 0.05). Conclusions DKA has a high incidence rate in children with type 1 diabetes, and the development of DKA is associated with age, parents' educational level, and family income.
TAO Na,WANG Ai-Ping,SUN Mei-Yuan et al. An investigation of ketoacidosis in children with newly diagnosed type 1 diabetes[J]. CJCP, 2017, 19(10): 1066-1069.
TAO Na,WANG Ai-Ping,SUN Mei-Yuan et al. An investigation of ketoacidosis in children with newly diagnosed type 1 diabetes[J]. CJCP, 2017, 19(10): 1066-1069.
Szypowska A, Skórka A. The risk factors of ketoacidosis in children with newly diagnosed type 1 diabetes mellitus[J]. Pediatr Diabetes, 2011, 12(4Pt1):302-306.
[2]
Ying AK, Lairson DR, Giardino AP, et al. Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes[J]. Pediatr Diabetes, 2011, 12(3 Pt 1):177-182.
[3]
Usher-Smith JA, Thompson M, Ercole A, et al. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children:a systematic review[J]. Diabetologia, 2012, 55(11):2878-2894
[4]
Ahmed AM, Al-Maghamsi M, Al-Harbi AM, et al. Reduced frequency and severity of ketoacidosis at diagnosis of childhood type 1 diabetes in Northwest Saudi Arabia[J]. J Pediatr Endocrinol Metab, 2016, 29(3):259-264.
[5]
Usher-Smith JA, Thompson M, Ercole A, et al. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children:a systematic review[J]. Diabetologia, 2012, 55(11):2878-2894.
[6]
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med, 1998, 15(7):539-553.
Kitabchi AE, Umpierrez GE, Murphy MB, et al. Hyperglyce-mic crises in adult patients with diabetes:a consensus statement from the American Diabetes Association[J]. Diabetes Care, 2006, 29(12):2739-2748.
[13]
Icks A, Strassburger K, Baechle C, et al. Frequency and cost of diabetic ketoacidosis in Germany——study in 12,001 paediatric patients[J]. Exp Clin Endocrinol Diabetes, 2013, 121(1):58-59.
Choleau C, Maitre J, Filipovic PA, et al. Ketoacidosis at diagnosis of type 1 diabetes in French children and adolescents[J]. Diabetes Metab, 2013, 40(2):137-142.
[17]
Oyarzabal M, García B, Barrio R, et al. Ketoacidosis at onset of type 1 diabetes mellitus in pediatric age in Spain and review of the literature[J]. Pediatr Endocrinol Rev, 2012, 9(3):669-671.
[18]
Quinn M, Fleischman A, Rosner B, et al. Characteristics at diagnosis of type 1 diabetes in children younger than 6 years[J]. J Pediatr, 2006, 148(3):366-371.
[19]
Bowden SA, Duck MM, Hoffman RP. Young children (<5 years) and adolescents (>12 years) with type 1 diabetes mellitus have low rate of partial remission:diabetic ketoacidosis is an important risk factor[J]. Pediatr Diabetes, 2008, 9(3 Pt 1):197- 201.
[20]
Karges B, Meissner T, Icks A, et al. Management of diabetes mellitus in infants[J]. Nat Rev Endocrinol, 2012, 8(4):201-211.
[21]
Forlenza GP, Rewers M. The epidemic of type 1 diabetes:what is it telling us[J]. Curr Opin Endocrinol Diabetes Obes, 2011, 18(4):248-251.
