ESPE Abstracts

Objective: To describe the differences in metabolic parameters and in time to recovery from Diabetes ketoacidosis (DKA), between children and adolescents with newly diagnosed compared with established Type 1 Diabetes (T1DM).

Methods: A single center, retrospective study. The cohort comprised 356 children and adolescents with T1DM who had DKA during 2008-2018. Data were obtained from the patients’ medical files. Recovery of DKA was defined as the resolution of acidosis (PH>7.3 and bicarbonate>15 meq/L).

Results: The mean time to recovery from DKA was significantly longer in patients with newly diagnosed than established diabetes (13± versus 8.5± hours) (P < 0.001). This difference was maintained in an analysis according to DKA severity: mild, moderate, and severe. PH at presentation did not differ between the groups, but bicarbonate at presentation was significantly lower in patients with newly diagnosed diabetes than in those with established diabetes, 9.9± versus 12± mmol/l (P < 0.001). Potassium and phosphorus levels were lower, and sodium and chloride levels were higher in patients with newly diagnosed diabetes than in those with established diabetes (P < 0.001).

Conclusion: DKA is associated with shorter recovery time in patients with established compared to newly diagnosed diabetes. This important finding can help clinicians plan treatment. Specifically, regardless of the severity of the DKA, clinicians can prepare for shorter intravenous treatment in patients with established diabetes, with the expectation of fewer complications.