engleski

Frequency of diabetic ketoacidosis at type 1 diabetes (T1D) onset in children under the age of 15 - experience of one center in the period between 1995 and 2015

Objective: Rapid progression of T1D or negligence of the first symptoms will cause complex metabolic decompensation and development of diabetic ketoacidosis (DKA). The aim of this study was to determine the frequency of DKA at T1D onset in our center in children under the age of 15 years over a period of 21 years. Subjects and Methods: The study included patients younger than 15 years in whom T1D was diagnosed between January 1st 1995 and December 31th 2015. Data regarding symptoms and signs at the beginning of the disease and laboratory findings were collected retrospectively from patients´ medical history. DKA was defined in two ways: 1. pH < 7.3 or 2. pH < 7.3 and / or bicarbonate level <15 mmol/l. Results: during the observed period 426 children under the age of 15 years (227 girls, 53.3%) were hospitalized due to new onset T1D. Polydipsia (90.4%), polyuria (89.7%), and weight loss (70.4%) were the most common symptoms present at the time of disease onset. Enuresis was recorded in 8.5% of patients and 43.9% had nicturia. In 20.3% of children, an infectious disease preceded or was present at the time of T1D detection. A total of 31.5% (134) patients had DKA at beginning of the disease when defined at pH < 7.3. According to the definition of DKA at pH < 7.3 and / or bicarbonate < 15 mmol/L DKA was present in 41.5% (177) patients. During the observed period there was no significant change in the DKA frequency in children under the age 15 years, but in children > 10 years there was a significant trend of DKA frequency increase (p 0.009). Conclusion: The frequency of DKA in children under 15 years at disease onset is high, 31.5%, and does not change in the observed period. One must extract children older than 10 years in which the frequency of DKA is increasing. Therefore, it is necessary to further emphasize the need for early identification of the basic symptoms of T1D in order to avoid a life threatening condition - DKA.

diabetic ketoacidosis ; type I diabetes

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