Moderate and severe diabetic ketoacidosis at type 1 diabetes onset in children over two decades: A population‐based study of prevalence and long‐term glycemic outcomes
| العنوان: | Moderate and severe diabetic ketoacidosis at type 1 diabetes onset in children over two decades: A population‐based study of prevalence and long‐term glycemic outcomes |
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| المؤلفون: | Helen Clapin, Grant Smith, Sathyakala Vijayanand, Timothy Jones, Elizabeth Davis, Aveni Haynes |
| المصدر: | Pediatric Diabetes. 23:473-479 |
| بيانات النشر: | Hindawi Limited, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Blood Glucose, Glycated Hemoglobin, Diabetes Mellitus, Type 1, Endocrinology, Diabetes and Metabolism, Pediatrics, Perinatology and Child Health, Prevalence, Internal Medicine, Humans, Child, Diabetic Ketoacidosis |
| الوصف: | To investigate in a population-based pediatric cohort: prevalence of moderate-severe diabetic ketoacidosis (DKA) at type 1 diabetes (T1D) diagnosis over two decades and its association with long-term glycemic control.Children16 years diagnosed with T1D in Western Australia 2000-2019 were included and followed up for ≤14 years. Moderate-severe DKA at diagnosis was defined as serum pH 7.2 or bicarbonate10 mmol/L with hyperglycemia and ketosis. HbA1c was measured ~3-monthly. Trend in prevalence of moderate-severe DKA at diagnosis was investigated using a logistic regression model adjusting for sex, age, socioeconomic status, and area of residence. Long-term glycemic control associated with DKA at diagnosis was investigated using linear mixed models adjusting for the same variables and also for visit frequency, CGM and pump use.Moderate-severe DKA occurred in 534 of 2111 (25.3%) participants. Odds of presenting with moderate-severe DKA increased by 4.1% (95% CI: 2.3, 5.9; p 0.001) per year. Patients with moderate-severe DKA at diagnosis had higher HbA1c levels than other patients initially; the groups were similar between 2 and 6 years duration; from 7 years HbA1c levels tracked higher in the group with moderate-severe DKA at diagnosis with significant differences at 8 and 12 years (p 0.05).The increasing prevalence of DKA at diagnosis of pediatric T1D is concerning and highlights the need for early detection programs. Unlike a similar US study, this study did not find a consistent, clinically significant relationship between DKA at diagnosis and long-term HbA1c, raising important questions about the influence of other factors on long-term glycemic outcomes. |
| تدمد: | 1399-5448 1399-543X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6d7dc269f45222b5f5c5eb3ea8c02879 https://doi.org/10.1111/pedi.13327 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....6d7dc269f45222b5f5c5eb3ea8c02879 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 13995448 1399543X |
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