Background: There is wide geographic variation in the frequency of diabetic ketoacidosis (DKA) at onset of diabetes from ~1570% in Europe and North America.
Objective and hypotheses: To evaluate the frequency of DKA at the onset of type 1 diabetes (T1D) in the paediatric population seen in the Department of Pediatric Diabetology of Turin (Italy) from 1/1/2008 to 31/12/2013.
Method: Data (venous pH and HCO3, season at the onset) of 305 children (mean age 8±6 years; M/F 1.16/1) at T1D onset were retrospectively analyzed. DKA was defined according to the ISPAD criteria.
Results: 117 of 305 children (38.4%) had DKA and 36 of 117 had a severe DKA (pH <7.1, HCO3< 5 mmol/l) (11.8%). M/F ratio was 1/1.2 (OR 0.613, IC 0.3850.976), revealing higher prevalence among females. Season onset evaluation showed a higher DKA frequency in summer (35%) than spring and autumn (respectively OR 0.477 IC 0.2230.896 and OR 0.4 IC 0.1980.804). Stratifying patients by age (04, 510 and >10 years), we observed a higher DKA prevalence in the 04 year age group (82 patients: 47.6% of all DKA cases and 15.8% of all severe DKA) which was greater than in the other age groups (respectively OR 0.738 IC 0.3351.628 and OR 0.458 IC 0.2450.855).
Conclusion: DKA at the onset of T1D still represents a frequent event, more so in children aged <5 years old, in which severe DKA prevalence is still too high with an increased risk of complications.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology