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Exploring ketoacidosis frequency and risk factors in childhood-onset type 1 diabetes: an 8-year retrospective study (2011–2018) at a tertiary paediatric hospital in Tripoli, Libya

  • Mostafa Sasi Shebani ORCID logo EMAIL logo and Rowida Mohammed Khashebi ORCID logo
Published/Copyright: May 3, 2024
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 37 Issue 6

Abstract

Objectives

Diabetic ketoacidosis (DKA) stands as a critical, acute complication of type 1 diabetes. Despite its severity, there exists a dearth of data concerning the frequency and prevalence of DKA at the onset of type 1 diabetes in Libyan children. This study aimed to ascertain the frequency of DKA during the initial presentation of type 1 diabetes among children aged 0.5–14 years admitted to Tripoli Children’s Hospital between 2011 and 2018.

Methods

Employing a retrospective approach, the study examined the proportion of children with newly diagnosed type 1 diabetes who presented with DKA. Data analysis included estimating DKA frequency concerning age at presentation, sex, and age groups. The comparative analysis involved assessing DKA frequency between 0.5 and <2 and 2–14 years age groups. Logistic regression analysis evaluated the impact of age group, sex, and family history of type 1 diabetes on DKA and severe DKA occurrence.

Results

Among 497 children with newly diagnosed type 1 diabetes, 39.2 % presented with DKA, of these 44.5 % had severe DKA. Females exhibited a higher DKA rate than males (OR 1.63, 95 % CI 1.13–2.34, p=0.009). Very young children (0.5 to <2 years) presented with DKA more frequently than those aged 2–14 years (OR 4.73, 95 % CI 2.65–8.47, p<0.001), and they were more likely to present in severe DKA (63.9 vs. 39.1 %, [OR 7.26, 95 % CI 3.65–14.41, p<0.001]).

Conclusions

The frequency of DKA at type 1 diabetes onset among children admitted to Tripoli Children’s Hospital is notably high, with nearly half of the DKA episodes categorized as severe. Very young children notably demonstrated a fivefold increase in the likelihood of presenting with DKA.

Keywords: adolescents; children; diabetic ketoacidosis; epidemiology; Libya; type 1 diabetes
Corresponding author: Dr. Mostafa Sasi Shebani, Paediatric Endocrinology and Diabetes Department, Tripoli Children’s Hospital, Omar Al Mukhtar Street, Tripoli, Libya; and Paediatric Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya, E-mail:
Mostafa Sasi Shebani and Rowida Mohammed Khashebi contributed equally to this work and share the first authorship.

Acknowledgements

The authors express gratitude to Professor Christopher Patterson (Queens’s University Belfast, Centre of Public Health, Belfast, UK) for giving statistical advice and to Dr. Hesham M. Khalleefah and Dr. Mahmoud D. Alnemni for their invaluable assistance in data collection. Special thanks are extended to Dr Houwayda M Al-Hagi, head of Human Resources at Tripoli Children’s Hospital, for her support and permission to utilize the human resource office facilities for conducting this study.

  1. Research ethics: Ethical approval for this study (Ref No; BEC-BTRC 26-2022) was obtained from the Bioethics Committee at the Biotechnology Research Centre, Tripoli, Libya.

  2. Informed consent: Not applicable.

  3. Author contributions: M.S.S.: conceived and designed the study, collected and reviewed the data for accuracy, conducted extensive data research, carried out analysis and data interpretation, and authored the manuscript. R.M.K.: contributed significantly to the study’s design, diligently collected and reviewed data accuracy, responsible for data entry into the SPSS file, researched data, conducted a portion of the statistical analysis, contributed to data interpretation and analysis, and co-authored the manuscript.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: The datasets generated during and/or analysed during current study are available from the corresponding author on reasonable request.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2024-0011).

Received: 2024-01-05
Accepted: 2024-03-29
Published Online: 2024-05-03
Published in Print: 2024-06-25

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Incidences of newly diagnosed childhood diabetes and onset severity: a multicenter regional study in Thailand over two decades and during the COVID-19 pandemic
  4. Exploring ketoacidosis frequency and risk factors in childhood-onset type 1 diabetes: an 8-year retrospective study (2011–2018) at a tertiary paediatric hospital in Tripoli, Libya
  5. Automated insulin delivery in children with type 1 diabetes during physical activity: a meta-analysis
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  7. Post hoc subgroup analysis of Asian children with paediatric GHD from the global phase 3 efficacy and safety study of once-weekly somatrogon vs. once-daily somatropin
  8. Familial dysalbuminemic hyperthyroxinemia (FDH) due to Arg242 His variant in ALB gene in Turkish children
  9. A novel useful marker in the early discrimination of transient hyperthyrotropinemia/hypothyroxinemia and congenital hypothyroidism in preterm infants: thyroid-stimulating hormone/free thyroxine ratio
  10. Comprehensive analyses of phenylalanine hydroxylase variants and phenotypic characteristics of patients in the eastern region of Türkiye
  11. Relationship between urinary sodium excretion and bone mineral density in pediatrics: population-based study from KNHANES V 2010–2011
  12. Trajectory of the body mass index of children and adolescents attending a reference mental health center
  13. Case Reports
  14. Prenatal presentation of a hyperfunctioning thyroid nodule
  15. A very rare presentation of mitochondrial elongation factor Tu deficiency-TUFM mutation and literature review
  16. Identification of a novel homozygous NR5A1 variant in a patient with a 46,XY disorders of sex development
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https://doi.org/10.1515/jpem-2024-0011
Keywords for this article
adolescents; children; diabetic ketoacidosis; epidemiology; Libya; type 1 diabetes

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Incidences of newly diagnosed childhood diabetes and onset severity: a multicenter regional study in Thailand over two decades and during the COVID-19 pandemic
  4. Exploring ketoacidosis frequency and risk factors in childhood-onset type 1 diabetes: an 8-year retrospective study (2011–2018) at a tertiary paediatric hospital in Tripoli, Libya
  5. Automated insulin delivery in children with type 1 diabetes during physical activity: a meta-analysis
  6. Association between maternal and cord blood thyroid hormones, and urine iodine concentration with fetal growth
  7. Post hoc subgroup analysis of Asian children with paediatric GHD from the global phase 3 efficacy and safety study of once-weekly somatrogon vs. once-daily somatropin
  8. Familial dysalbuminemic hyperthyroxinemia (FDH) due to Arg242 His variant in ALB gene in Turkish children
  9. A novel useful marker in the early discrimination of transient hyperthyrotropinemia/hypothyroxinemia and congenital hypothyroidism in preterm infants: thyroid-stimulating hormone/free thyroxine ratio
  10. Comprehensive analyses of phenylalanine hydroxylase variants and phenotypic characteristics of patients in the eastern region of Türkiye
  11. Relationship between urinary sodium excretion and bone mineral density in pediatrics: population-based study from KNHANES V 2010–2011
  12. Trajectory of the body mass index of children and adolescents attending a reference mental health center
  13. Case Reports
  14. Prenatal presentation of a hyperfunctioning thyroid nodule
  15. A very rare presentation of mitochondrial elongation factor Tu deficiency-TUFM mutation and literature review
  16. Identification of a novel homozygous NR5A1 variant in a patient with a 46,XY disorders of sex development
  17. Use of [18F]fluorocholine PET/CT in the detection of primary hyperparathyroidism in paediatrics: a case report
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