ESPE Abstracts (2014) 82 P-D-2-3-356

Diabetic Ketoacidosis at the Onset of Type I Diabetes: a Retrospective Study in a Paediatric Population

Gerdi Tuli, Giovanna Maria Ignaccolo, Davide Tinti, Elisa Gioia, Sabrina Sicignano, Franco Cerutti & Ivana Rabbone


Department of Pediatric Diabetology and Endocrinology, University of Turin, Turin, Italy


Background: There is wide geographic variation in the frequency of diabetic ketoacidosis (DKA) at onset of diabetes from ~15–70% 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 0.385–0.976), 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 0.223–0.896 and OR 0.4 IC 0.198–0.804). Stratifying patients by age (0–4, 5–10 and >10 years), we observed a higher DKA prevalence in the 0–4 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 0.335–1.628 and OR 0.458 IC 0.245–0.855).

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.

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