ESPE Abstracts

Introduction: Diabetic ketoacidosis is a frequent reason for hospital admission of children with newly diagnosed diabetes and the most frequent cause for hospitalization of children with poorly controlled diabetes.

Aim: To evaluate the frequency of diabetic ketoacidosis (DKA) hospitalization for pediatric patients and resources for its decrease.

Methods: Subjects included children <19 years who hospitalized with DKA in the pediatric diabetes care units during one year. The study entry criteria were venous pH <7.30 and/or bicarbonate <15 mmol/l and ketonuria. Patients were treated with fluid replacement and insulin infusion. The patients were analyzed according to demographic data, clinical and laboratory findings.

Results: One hundred and twenty four DKA patients (72 boys and 52 girls) were hospitalized during the study period. Pediatric DKA accounted for 1739 hospital days (median length of stay 14 days). 38 children (30.6%) were with new-onset diabetes. The frequency of DKA at onset of diabetes was equal 92%. The risk of presenting with DKA was the highest among patients <5 years old. 86 patients were with early diagnosed diabetes and duration of disease from 2 months to 12 years. Compared with single episode DKA, recurrent DKA (46.2%) was highest among children with poorly controlled diabetes, prepubertal and adolescent boys, children with difficult family circumstances.

Conclusion: The carried out research was shown high frequency of DKA at onset of diabetes, recurrent DKA among adolescent boys and children with difficult family circumstances. Opportunities exist to reduce DKA hospitalizations for children with diabetes with clinical and policy interventions targeted to this population.