Ketoacidosis at presentation of type 1 diabetes mellitus in children: a retrospective 20-year experience from a tertiary care hospital in Serbia

Autor:	Vladislav Bojic, Danijela Trifunović, Svetislav Necić, Milos Jesic, Mira Vranješ, Dejana Stanisavljević, Maja Jesic, Vera Zdravkovic, Silvija Sajic
Rok vydání:	2013
Předmět:	Blood Glucose Male Risk Pediatrics medicine.medical_specialty Adolescent endocrine system diseases Diabetic ketoacidosis Severity of Illness Index Statistics Nonparametric Diabetic Ketoacidosis Diabetes mellitus Severity of illness Humans Medicine Child Retrospective Studies Analysis of Variance Type 1 diabetes Tertiary Healthcare business.industry Age Factors Infant nutritional and metabolic diseases Retrospective cohort study medicine.disease Ketoacidosis Diabetes Mellitus Type 1 Child Preschool Pediatrics Perinatology and Child Health Population study Female Presentation (obstetrics) business Serbia
Zdroj:	European Journal of Pediatrics. 172:1581-1585
ISSN:	1432-1076 0340-6199
DOI:	10.1007/s00431-013-2083-7
Popis:	Diabetic ketoacidosis (DKA) has significant morbidity and mortality and is common at diagnosis in children. The aim of this study was to determine the frequency and clinical characteristics of DKA over a 20-year period among children diagnosed with type 1 diabetes mellitus (T1DM) at University children's hospital in Belgrade, Serbia. The study population comprised of 720 patients (366 boys) diagnosed with type 1 diabetes aged18 years between January 1992 and December 2011. Of all patients diagnosed with T1DM, 237 (32.9 %) presented with DKA. The majority had either mild (69.6 %) or moderate (22.8 %) DKA. Sixty (55.0 %) of all children under 5 years had DKA compared to sixty-two (20.9 %) in the 5- to 10-year-old group and one hundred fifteen (36.6 %) in the 11- to 18-year-old patients (p0.01), while 2.5 % of the entire DKA cohort were in real coma. During the later 10-year period, children less often had DKA at diagnosis compared with the earlier 10-year period (28.0 vs. 37.4 %) (p0.01), but the frequency of severe DKA was higher in the age group5 year and in the age group11 year during 2002-2011, compared with the earlier 10-year period (12.9 vs. 3.4 %, p0.01 and 17.1 vs. 3.8 %, p0.01).The overall frequency of DKA in children with newly diagnosed type 1 diabetes decreased over a 20-year period at our hospital. However, children aged5 years and adolescents are still at high risk for DKA at diagnosis.
Databáze:	OpenAIRE
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