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Diabetic ketoacidosis in children with new-onset type 1 diabetes mellitus: demographics, risk factors and outcome: an 11 year review in Hong Kong.
- Source :
-
Journal of pediatric endocrinology & metabolism : JPEM [J Pediatr Endocrinol Metab] 2022 Aug 24; Vol. 35 (9), pp. 1132-1140. Date of Electronic Publication: 2022 Aug 24 (Print Publication: 2022). - Publication Year :
- 2022
-
Abstract
- Objectives: Diabetic ketoacidosis (DKA) is a life-threatening complication of type 1 diabetes (T1D). The aim of this study is to analyze the incidence, clinical characteristics, management and outcome of children presenting with DKA in new-onset T1D from 2008 to 2018 in Hong Kong.<br />Methods: Data was extracted from the Hong Kong Childhood Diabetes Registry. All subjects less than 18 years with newly diagnosed T1D from 1 January 2008 to 31 December 2018 managed in the public hospitals were included. Information on demographics, laboratory parameters, DKA-related complications and management were analyzed.<br />Results: In the study period, there were 556 children with newly diagnosed T1D in our registry and 43.3% presented with DKA. The crude incidence rate of new-onset T1D with DKA was 1.79 per 100,000 persons/year (CI: 1.56-2.04). Subjects presenting with DKA were younger (9.5 ± 4.5 vs. 10.5 ± 4.4, p=0.01) and had shorter duration of symptoms (4.2 ± 5.9 days vs. 10.6 ± 17.1 days, p<0.01). Regarding management, up to 12.4% were given insulin boluses and 82.6% were started on insulin infusion 1 h after fluid resuscitation. The rate of cerebral edema was 0.8% and there was no mortality.<br />Conclusions: Younger age and shorter duration of symptoms were associated with DKA in new-onset T1D. Despite availability of international guidelines, there was inconsistency in acute DKA management. These call for a need to raise public awareness on childhood diabetes as well as standardization of practice in management of pediatric DKA in Hong Kong.<br /> (© 2022 the author(s), published by De Gruyter, Berlin/Boston.)
- Subjects :
- Child
Hong Kong epidemiology
Humans
Incidence
Insulin therapeutic use
Risk Factors
Diabetes Mellitus, Type 1 complications
Diabetes Mellitus, Type 1 epidemiology
Diabetes Mellitus, Type 1 therapy
Diabetic Ketoacidosis epidemiology
Diabetic Ketoacidosis etiology
Diabetic Ketoacidosis therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2191-0251
- Volume :
- 35
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of pediatric endocrinology & metabolism : JPEM
- Publication Type :
- Academic Journal
- Accession number :
- 36001345
- Full Text :
- https://doi.org/10.1515/jpem-2022-0255