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The risk factors of ketoacidosis in children with newly diagnosed type 1 diabetes mellitus.
MedLine Citation:
PMID:  21129138     Owner:  NLM     Status:  In-Data-Review    
Szypowska A, Skórka A. The risk factors of ketoacidosis in children with newly diagnosed type 1 diabetes mellitus. Background and aims: Diabetic ketoacidosis (DKA) is still a severe complication associated with significant morbidity and mortality. The aim of this study was to determine the predictors of DKA in children with newly diagnosed type 1 diabetes mellitus (T1DM). Material and methods: The study group consisted of new-onset type 1 diabetic patients admitted to our hospital between January 2006 and March 2008. One hundred and eighty-seven children were identified (95 females and 92 males) and their mean age was 8.9 ± 4.6 yr (0.8-17.8). Hemoglobin A1c, blood gases, and fasting c-peptide level were evaluated in all children. DKA was defined as a capillary pH < 7.3 and blood glucose >11 mmol/L. Results: At the time of T1DM diagnosis, 26% of children had DKA. Misdiagnosis was significantly associated with the incidence of DKA. In the group with DKA, c-peptide level was significantly lower than in the group without DKA (p = 0.003.) The most prone to DKA were children under 2 yr of age (n = 14). In this age group, DKA was present in 71% of individuals and the lowest c-peptide level was observed compared to older children (p < 0.0001). There was significant correlation between the c-peptide level and age of children (r = 0.41, p < 0.0001). Conclusions: The incidence of DKA among newly diagnosed patients with T1DM remains unacceptably high and indicates greater necessity of medical alertness for this diagnosis, especially in the youngest children. Children under 2 yr of age remain the most prone to DKA, which may be related to delay in diagnosis and more aggressive β-cell destruction.
Agnieszka Szypowska; Agata Skórka
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Publication Detail:
Type:  Journal Article     Date:  2010-12-05
Journal Detail:
Title:  Pediatric diabetes     Volume:  12     ISSN:  1399-5448     ISO Abbreviation:  Pediatr Diabetes     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100939345     Medline TA:  Pediatr Diabetes     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  302-6     Citation Subset:  IM    
Copyright Information:
© 2010 John Wiley & Sons A/S.
Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
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