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.

التفاصيل البيبلوغرافية
العنوان:	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.
المؤلفون:	Shebani MS; Paediatric Endocrinology and Diabetes Department, 612518 Tripoli Children's Hospital , Tripoli, Libya.; Paediatric Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya., Khashebi RM; Paediatric Endocrinology and Diabetes Department, 612518 Tripoli Children's Hospital , Tripoli, Libya.; Paediatric Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya.
المصدر:	Journal of pediatric endocrinology & metabolism : JPEM [J Pediatr Endocrinol Metab] 2024 May 03; Vol. 37 (6), pp. 497-504. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Walter de Gruyter Country of Publication: Germany NLM ID: 9508900 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 2191-0251 (Electronic) Linking ISSN: 0334018X NLM ISO Abbreviation: J Pediatr Endocrinol Metab Subsets: MEDLINE
أسماء مطبوعة:	Publication: Mar. 2011- : Berlin : Walter de Gruyter Original Publication: London : Freund Pub. House, [1995-
مواضيع طبية MeSH:	Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/complications , Diabetic Ketoacidosis/epidemiology , Diabetic Ketoacidosis/etiology , Tertiary Care Centers*/statistics & numerical data, Humans ; Male ; Female ; Child ; Retrospective Studies ; Libya/epidemiology ; Adolescent ; Child, Preschool ; Risk Factors ; Infant ; Prevalence ; Hospitals, Pediatric/statistics & numerical data ; Follow-Up Studies ; Prognosis
مستخلص:	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. (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)
References:	Libman, I, Haynes, A, Lyons, S, Pradeep, P, Rwagasor, E, Tung, JYL, et al.. ISPAD clinical practice consensus guidelines 2022: definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 2022;23:1160–74. https://doi.org/10.1111/pedi.13454 . (PMID: 10.1111/pedi.13454) Tuomilehto, J, Ogle, GD, Lund-Blix, NA, Stene, LC. Update on worldwide trends in occurrence of childhood type 1 diabetes in 2020. Pediatr Endocrinol Rev 2020;17:198–209. https://doi.org/10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetes . (PMID: 10.17458/per.vol17.2020.tol.epidemiologychildtype1diabetes) International Diabetes Federation . IDF diabetes Atlas , 10th ed.; 2021. https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf [Accessed 6 Dec 2021]. Khashebi, RM, Patterson, CC, Shebani, MS. The incidence trend of type 1 diabetes among children and adolescents 0-14 years of age in the West, South, and Tripoli regions of Libya (2009–2018). J Clin Res Pediatr Endocrinol 2023;15:356–64. https://doi.org/10.4274/jcrpe.galenos.2023.2023-1-17 . (PMID: 10.4274/jcrpe.galenos.2023.2023-1-17) Wersäll, JH, Adolfsson, P, Forsander, G, Ricksten, S-E, Hanas, R. Delayed referral is common even when new-onset diabetes is suspected in children. A Swedish prospective observational study of diabetic ketoacidosis at onset of type 1 diabetes. Pediatr Diabetes 2021;22:900–8. https://doi.org/10.1111/pedi.13229 . (PMID: 10.1111/pedi.13229) Wolfsdorf, JI, Glaser, N, Agus, M, Fritsch, M, Hanas, R, Rewers, A, et al.. ISPAD clinical practice consensus guidelines 2018: diabetic ketoacidosis and the hyperglycemic hyperosmolar state. Pediatr Diabetes 2018;19:155–77. https://doi.org/10.1111/pedi.12701 . (PMID: 10.1111/pedi.12701) Besser, REJ, Bell, KJ, Couper, JJ, Ziegler, AG, Wherrett, DK, Knip, M, et al.. ISPAD clinical practice consensus guidelines 2022: stages of type 1 diabetes in children and adolescents. Pediatr Diabetes 2022;23:1175–87. https://doi.org/10.1111/pedi.13410 . (PMID: 10.1111/pedi.13410) Usher-Smith, JA, Thompson, M, Ercole, A, Walter, FM. Variation between countries in the frequency of diabetic ketoacidosis at first presentation of type 1 diabetes in children: a systematic review. Diabetologia 2012;55:2878–94. https://doi.org/10.1007/s00125-012-2690-2 . (PMID: 10.1007/s00125-012-2690-2) Mencher, SR, Frank, G, Fishbein, J. Diabetic ketoacidosis at onset of type 1 diabetes: rates and risk factors today to 15 years ago. Global Pediatr Health 2019;6:1–9. https://doi.org/10.1177/2333794x19870394 . (PMID: 10.1177/2333794x19870394) Sundaram, PCB, Day, E, Kirk, JMW. Delayed diagnosis in type 1 diabetes mellitus. Arch Dis Child 2008;94:151–2. https://doi.org/10.1136/ADC.2007.133405 . (PMID: 10.1136/ADC.2007.133405) Mallare, JT, Cordice, CC, Ryan, BA, Carey, DE, Kreitzer, PM, Frank, GR. Identifying risk factors for the development of diabetic ketoacidosis in new-onset type 1 diabetes mellitus. Clin Pediatr 2003;42:591–7. https://doi.org/10.1177/000992280304200704 . (PMID: 10.1177/000992280304200704) Edge, JA, Hawkins, MM, Winter, DL, Dunger, DB. The risk and outcome of cerebral oedema developing during diabetic ketoacidosis. Arch Dis Child 2001;85:16–22. https://doi.org/10.1136/adc.85.1.16 . (PMID: 10.1136/adc.85.1.16) Dahlquist, G, Källén, B. Mortality in childhood-onset type 1 diabetes: a population-based study. Diabetes Care 2005;28:2384–7. https://doi.org/10.2337/diacare.28.10.2384 . (PMID: 10.2337/diacare.28.10.2384) Cherubini, V, Grimsmann, JM, Åkesson, K, Birkebæk, NH, Cinek, O, Dovč, K, et al.. Temporal trends in diabetic ketoacidosis at diagnosis of paediatric type 1 diabetes between 2006 and 2016: results from 13 countries in three continents. Diabetologia 2020;63:1530–41. https://doi.org/10.1007/s00125-020-05152-1 . (PMID: 10.1007/s00125-020-05152-1) Zayed, H. Epidemiology of diabetic ketoacidosis in Arab patients with type 1 diabetes: a systematic review. Int J Clin Pract 2016;70:186–95. https://doi.org/10.1111/ijcp.12777 . (PMID: 10.1111/ijcp.12777) Kadiki, OA, Gerryo, SE, Khan, MM. Childhood diabetes mellitus in Benghazi (Libya). J Trop Pediatr 1987;33:136–9. https://doi.org/10.1093/tropej/33.3.136 . (PMID: 10.1093/tropej/33.3.136) Libyan Ministry of Health, World. Service availability and readiness assessment, final 12-03-2018.pdf. Google Drive; 2018. https://drive.google.com/file/d/1BPlg2hMyfW94T_9GnsLGp9bvXO8T8fcE/view [Accessed 2 Feb 2020]. Libyan Center for Research and Biotechnology. Main page; 2021. http://www.btc.org.ly/new-btc/index.php/ar [Accessed 17 April 2021]. World Health Organization . Standards; n.d. https://www.who.int/tools/child-growth-standards/standards [Accessed 12 February 2023]. Mayer-Davis, EJ, Kahkoska, AR, Jefferies, C, Dabelea, D, Balde, N, Gong, CX, et al.. ISPAD clinical practice consensus guidelines 2018: definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes 2018;19(2 Suppl):7–19. https://doi.org/10.1111/pedi.12773 . (PMID: 10.1111/pedi.12773) Beck, RW, Tamborlane, WV, Bergenstal, RM, Miller, KM, DuBose, SN, Hall, CA. The T1D exchange clinic registry. J Clin Endocrinol Metab 2012;97:4383–9. https://doi.org/10.1210/jc.2012-1561 . (PMID: 10.1210/jc.2012-1561) Manuwald, U, Schoffer, O, Hegewald, J, Große, J, Kugler, J, Kapellen, TM, et al.. Ketoacidosis at onset of type 1 diabetes in children up to 14 years of age and the changes over a period of 18 years in Saxony, Eastern-Germany: a population-based register study. PLoS One 2019;14:e0218807. https://doi.org/10.1371/journal.pone.0218807 . (PMID: 10.1371/journal.pone.0218807) Nagl, K, Waldhör, T, Hofer, SE, Fritsch, M, Meraner, D, Prchla, C, et al.. Alarming increase of ketoacidosis prevalence at type 1 diabetes-onset in Austria. Results from a nationwide registry. Front Pediatr 2022;10:820156. https://doi.org/10.3389/fped.2022.820156 . (PMID: 10.3389/fped.2022.820156) Rabbone, I, Maltoni, G, Tinti, D, Zucchini, S, Cherubini, V, Bonfanti, R, et al.. Diabetic ketoacidosis at the onset of disease during a national awareness campaign: a 2-year observational study in children aged 0-18 years. Arch Dis Child 2020;105:363–6. https://doi.org/10.1136/archdischild-2019-316903 . (PMID: 10.1136/archdischild-2019-316903) Jensen, ET, Stafford, JM, Saydah, S, D’agostino, RB, Dolan, LM, Lawrence, JM, et al.. Increase in prevalence of diabetic ketoacidosis at diagnosis among youth with type 1 diabetes: the SEARCH for diabetes in youth study. Diabetes Care 2021;44:1573–8. https://doi.org/10.2337/dc20-0389 . (PMID: 10.2337/dc20-0389) Robinson, ME, Li, P, Rahme, E, Simard, M, Larocque, I, Nakhla, MM. Increasing prevalence of diabetic ketoacidosis at diabetes diagnosis among children in Quebec: a population-based retrospective cohort study. Can Med Assoc J Open 2019;7:E300–5. https://doi.org/10.9778/cmajo.20190047 . (PMID: 10.9778/cmajo.20190047) Alonso, GT, Coakley, A, Pyle, L, Manseau, K, Thomas, S, Rewers, A. Diabetic ketoacidosis at diagnosis of type 1 diabetes in Colorado children, 2010–2017. Diabetes Care 2020;43:117 LP–121. https://doi.org/10.2337/dc19-0428 . (PMID: 10.2337/dc19-0428) Ahmed, AM, Al-Maghamsi, M, Al-Harbi, AM, Eid, IM, Baghdadi, HH, Habeb, AM. Reduced frequency and severity of ketoacidosis at diagnosis of childhood type 1 diabetes in Northwest Saudi Arabia. JPEM (J Pediatr Endocrinol Metab) 2016;29:259–64. https://doi.org/10.1515/jpem-2015-0077 . (PMID: 10.1515/jpem-2015-0077) Al-Abdulrazzaq, D, Othman, F, Qabazard, S, Al-Tararwa, A, Ahmad, D, Al-Sanae, H, et al.. Epidemiological trends in the presentation of diabetic ketoacidosis in children newly diagnosed with type 1 diabetes from 2011 to 2017 in Kuwait. Front Endocrinol 2022;13:908458. https://doi.org/10.3389/fendo.2022.908458 . (PMID: 10.3389/fendo.2022.908458) Abdel-Karim, T, Haris, B, Afyouni, H, Mohammed, S, Khalifa, A, Al-Maadheed, M, et al.. The epidemiology and genetic analysis of children with idiopathic type 1 diabetes in the state of Qatar. J Endocr Soc 2021;5:1–7. https://doi.org/10.1210/jendso/bvab131 . (PMID: 10.1210/jendso/bvab131) Babiker, A, Aljahdali, GL, Alsaeed, MK, Almunif, AF, Mohamud, MS, Al, MA, et al.. Frequency and risk factors of diabetic ketoacidosis in a specialized children’s hospital, Riyadh: a cross-sectional study. Oman Med J 2022;37:e341. https://doi.org/10.5001/omj.2021.124 . (PMID: 10.5001/omj.2021.124) Al-Ghamdi, AH, Fureeh, AA. Prevalence and clinical presentation at the onset of type 1 diabetes mellitus among children and adolescents in AL-Baha region, Saudi Arabia. JPEM (J Pediatr Endocrinol Metab) 2018;31:269–73. https://doi.org/10.1515/jpem-2017-0059 . (PMID: 10.1515/jpem-2017-0059) Odeh, R, Alassaf, A, Ajlouni, K. Clinical and biochemical features at diagnosis of type 1 diabetes in patients between 0 and 18 years of age from Jordan. Pediatr Diabetes 2018;19:707–12. https://doi.org/10.1111/pedi.12625 . (PMID: 10.1111/pedi.12625) Khlifi, A, Farih, S, Imane, Z. Epidemiological profile of type 1 diabetes in children: about 971 Patients. Acad J Pediatr Neonatol 2019;7:1–3. https://doi.org/10.19080/ajpn.2019.07.555778 . (PMID: 10.19080/ajpn.2019.07.555778) Aminzadeh, M, Navidi, N, Valavi, E, Aletayeb, SMH. Childhood-onset type 1 diabetes at a tertiary hospital in southwestern Iran during 2000–2015: rapid increase in admissions and high prevalence of DKA at diagnosis. Prim Care Diabetes 2019;13:43–8. https://doi.org/10.1016/j.pcd.2018.07.013 . (PMID: 10.1016/j.pcd.2018.07.013) Batwa, M, Alharthi, L, Ghazal, R, Alsulami, M, Slaghour, R, Aljuhani, R, et al.. Diabetic Ketoacidosis at the onset of type 1 diabetes mellitus among children and adolescents in Jeddah, Saudi Arabia: a study from the emergency department. Cureus 2022;14:e24556. https://doi.org/10.7759/cureus.24456 . (PMID: 10.7759/cureus.24456) Khater, S, Aouar, A, Bensmain, N, Bendedouche, S, Chabni, N, Hamdaoui, H, et al.. Very high incidence of type 1 diabetes among children aged under 15 years in Tlemcen, Northwest Algeria (2015-2018). J Clin Res Pediatr Endocrinol 2021;13:44. https://doi.org/10.4274/jcrpe.galenos.2020.2020.0073 . (PMID: 10.4274/jcrpe.galenos.2020.2020.0073) Odeh, R, Gharaibeh, L, Daher, A, Albaramki, J, Ashour, B, Al Barakat, F, et al.. Frequency, clinical characteristics and predictors of ketoacidosis at diagnosis of type one diabetes mellitus in children and adolescents from Jordan. J Clin Res Pediatr Endocrinol 2023;15:46–54. https://doi.org/10.4274/jcrpe.galenos.2022.2022-5-8 . (PMID: 10.4274/jcrpe.galenos.2022.2022-5-8) Shaltout, AA, Channanath, AM, Thanaraj, TA, Omar, D, Abdulrasoul, M, Zanaty, N, et al.. Ketoacidosis at first presentation of type 1 diabetes mellitus among children: a study from Kuwait. Sci Rep 2016;6:27519. https://doi.org/10.1038/srep27519 . (PMID: 10.1038/srep27519) Usher-Smith, JA, Thompson, MJ, Sharp, SJ, Walter, FM. Factors associated with the presence of diabetic ketoacidosis at diagnosis of diabetes in children and young adults: a systematic review. BMJ 2011;343:d4092. https://doi.org/10.1136/bmj.d4092 . (PMID: 10.1136/bmj.d4092)
فهرسة مساهمة:	Keywords: Libya; adolescents; children; diabetic ketoacidosis; epidemiology; type 1 diabetes
تواريخ الأحداث:	Date Created: 20240502 Date Completed: 20240605 Latest Revision: 20240605
رمز التحديث:	20240605
DOI:	10.1515/jpem-2024-0011
PMID:	38695494
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	2191-0251
DOI:	10.1515/jpem-2024-0011