Frequency and severity of ketoacidosis at onset of autoimmune type 1 diabetes over the past decade in children referred to a tertiary paediatric care centre: potential impact of a national programme highlighted
-
Ahmet Uçar
,
Nurçin Saka
Abstract
Aims: To assess the frequency and severity of diabetic ketoacidosis (DKA) at disease onset in children newly diagnosed with autoimmune type 1 diabetes (T1D) in Istanbul in the last decade. Also, to evaluate the potential contribution of the national diabetes awareness programme (NDAP) initiated in 2010.
Methods: Four hundred and one consecutive children (mean±standard deviation, age 8.1±4.1 years) with a diagnosis of autoimmune T1D were evaluated retrospectively with respect to demographic, clinical, and laboratory data in relation to DKA at disease onset. The possible impact of NDAP on the rate of DKA at disease onset in the last 2 years was also evaluated by comparing the data related to the time intervals before and after the onset of the programme. The results were evaluated at 95% confidence interval and significance was granted for p≤0.05.
Results: The overall frequency of DKA at disease onset was 44.2%, with a significant trend for decline in rate of DKA at disease onset in the last decade (p=0.0001). There were no significant differences in proportions of newly diagnosed T1D patients with severe or moderate DKA over time. Mean body mass index standard deviation score tended to increase in the last decade, but not significantly (p=0.09). When the time intervals before and after the onset of NDAP were evaluated, there was a more than two-fold decrease in rate of DKA (from 49.3% to 23.9%) (p<0.0001).
Conclusions: The frequency of a DKA event at onset of T1D is still high in Istanbul children despite a decreasing trend in the last decade. NDAP may significantly contribute to the reduction in rate of DKA.
References
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©2013 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- Masthead
- Masthead
- Review article
- Application of imaging modalities for evaluating neuroblastoma
- Images in pediatric endocrinology
- Lingual thyroid
- Original articles
- A levothyroxine dose recommendation for the treatment of children and adolescents with autoimmune thyroiditis induced hypothyroidism
- Fasting glucagon-like peptide-1 in patients with overt hyperthyroidism and euthyroid congenital hypothyroidism
- Perinatal complications and higher risks of offspring thyroid dysfunction in early childhood of Graves’ disease mothers with euthyroidism
- Clinical characteristics and management of cranial diabetes insipidus in infants
- Desmopressin administration in children with central diabetes insipidus: a retrospective review
- An electronic surveillance system for monitoring the hospital presentation of nutritional vitamin D deficiency in children in Scotland
- Frequency and severity of ketoacidosis at onset of autoimmune type 1 diabetes over the past decade in children referred to a tertiary paediatric care centre: potential impact of a national programme highlighted
- Vitamin D status is associated with early markers of cardiovascular disease in prepubertal children
- Evaluation of bone mineral density in children with type 1 diabetes mellitus
- Observational study of diabetes management in type 1 diabetic school-age children during holiday versus school days
- Relationship of body mass index and GAD65 antibody status on β-cell secretion at diabetes onset in African-American children
- Serum dipeptidyl peptidase 4 activity in children with type 1 diabetes mellitus
- Concomitant autoantibodies in newly diagnosed diabetic children with transient celiac serology or proven celiac disease
- Assessment of user-friendliness of the Norditropin FlexPro for pediatric patients treated with recombinant human growth hormone: results of an open-label user survey
- Cognitive impairment and gray/white matter volume abnormalities in pediatric patients with Turner syndrome presenting with various karyotypes
- Prevalence of metabolic syndrome among urban Indian adolescents and its relation with insulin resistance (HOMA-IR)
- Prevalence of metabolic syndrome in obese Chilean children and association with gene variants of the leptin-melanocortin system
- Evaluation of serum neopterin levels and its relationship with adipokines in pediatric obesity-related nonalcoholic fatty liver disease and healthy adolescents
- Could GSD type I expand the spectrum of disorders with elevated plasma chitotriosidase activity?
- Patient reports
- Treatment of hyperinsulinemic hypoglycemia because of diffuse nesidioblastosis with nifedipine after surgical therapies in a newborn
- Successful subcutaneous glucagon use for persistent hypoglycaemia in congenital hyperinsulinism
- A novel atypical presentation of insulin autoimmune syndrome (Hirata’s disease) in a child
- Diagnosis of septo-optic dysplasia in a neonate with hypernatremia, hypoglycemia, and persistent hypothermia
- Speech and language delay in two children: an unusual presentation of hyperthyroidism
- Lissencephaly presenting with congenital hypothyroidism
- PHEX gene mutation in a Chinese family with six cases of X-linked hypophosphatemic rickets
- Primary hyperparathyroidism as an extremely rare cause of secondary myelofibrosis in childhood
- A family with Camurati-Engelman disease: the role of the missense p.R218C mutation in TGFbeta1 in bones and endocrine glands
- A case of SCNN1A splicing mutation presenting as mild systemic pseudohypoaldosteronism type 1
- Central precocious puberty in a girl with Prader-Willi syndrome
- Type 1 diabetes mellitus in a patient with homozygous sickle cell anemia
- Short communication
- No impact of obesity susceptibility loci on weight regain after a lifestyle intervention in overweight children
- Letter to the Editor
- Reliability and validity of homeostasis model assessment for insulin resistance and β-cell dysfunction in critically ill children with hyperglycemia
