For Debate: Paediatric T1DM: DKA is Still a Problem

Pediatr Endocrinol Rev. 2018 Dec;16(2):233-239. doi: 10.17458/per.vol16.2018.mpr.fd.t1dmdka.

Abstract

Although the treatment of pediatric patients with T1DM has improved ketoacidosis (DKA) remains a frequent problem.

Objective: To estimate temporal changes in the prevalence of DKA at diagnosis of T1DM and to explore the factors associated with its occurrence.

Methods: Paediatric patients diagnosed at Cruces University Hospital (Spain) since 1997 were included. Clinical/analytical variables at diabetes onset, Hemoglobin A1c level during the first 2 years of evolution and the presence of the honeymoon phase were studied.

Results: In 209 patients the prevalence of DKA was stable over time and high (35.4%) especially in the youngest. 8.5% of patients had a severe DKA with a higher risk in older than 10. Partial remission occurred in 26% patients, less frequent in the youngest and in the subgroup with DKA at diagnosis.

Conclusion: The frequency of DKA although stable, remains high and is associated with a worse evolution of the disease.

Keywords: Childhood; Diabetic Ketoacidosis; Honeymoon phase; Type 1 Diabetes mellitus.

Publication types

  • Editorial

MeSH terms

  • Child
  • Diabetes Mellitus, Type 1* / complications
  • Diabetic Ketoacidosis* / complications
  • Glycated Hemoglobin
  • Humans
  • Prevalence

Substances

  • Glycated Hemoglobin A