DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20181258

DKA as initial presentation in children with Type 1 diabetes mellitus-risk factors: a case control study

Merceline Alice PonJeba J., Poovazhagi Varadarajan

Abstract


Background: Diabetic keto acidosis (DKA) is a serious complication of pediatric diabetic patients, which leads to increased morbidity and mortality in children. Objective of the present study was to assess the risk factors associated of DKA for initial presentation among pediatric type 1 diabetes mellitus (T1DM) patients and its poor outcome.

Methods: A case control study was designed and conducted at the Institute of Child Health and Hospital for children, Madras Medical College, Chennai from February 2013 to February 2015. All children admitted with new onset T1DM either with or without DKA were enrolled for this study.

Results: Out of 72 cases of T1DM, 47 children with DKA were considered as cases and 25 children without DKA were considered as controls. On comparing both the groups Age, gender, place of residence, BMI were similar .Major risk factors for presentation as DKA were lack of family history of diabetes, shorter duration of illness and delayed diagnosis in the form of higher number of medical visits prior to DKA diagnosis. Six among 47 DKA died while none in control group died.

Conclusions: Short duration of illness and missing the diagnosis was significantly associated with initial presentation as DKA among children with Type 1 diabetes.

 


Keywords


DKA, Outcome, T1DM, Risk factors,

Full Text:

PDF

References


Poovazhagi V. Risk factors for mortality in children with diabetic keto acidosis from developing countries. World J Diabetes. 2014;5(6):932-8.

Onyiriuka AN, Ifebi E. Ketoacidosis at diagnosis of type 1 diabetes in children and adolescents: frequency and clinical characteristics. J Diabet Metabol Disorders. 2013;12:47.

International Diabetes Federation. Diabetes Atlas. 5th ed. 2011.

Levy-Marchal C, Patterson C, Green A. Geographic variation of presentation at diagnosis of type1 diabetes in children: the EURODIAB study. Diabetologia. 2001;44:B75-B80.

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(11):2878-94.

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.

Kamal Alanani NM, Alsulaimani AA. Epidemiological pattern of newly diagnosed children with type 1 diabetes mellitus, Taif, Saudi Arabia. Scientific World J. 2013;2013:421-569.

Pawłowicz M, Birkholz D, Niedźwiecki M, Balcerska A. Difficulties or mistakes in diagnosing type 1 diabetes mellitus in children? The consequences of delayed diagnosis. Pediatr Endocrinol Diabetes Metab. 2008;14(1):7-12.

Sundaram PC, Day E, Kirk JM. Delayed diagnosis in type 1 diabetes mellitus. Arch Dis Child. 2009;94(2):151-2.

Basavanthappa SP, Pejaver R, Raghavendra K, Srinivasa V, Suresh Babu MT. Clinical profile and outcome of diabetic ketoacidosis in a tertiary care hospital in South India. Int J Contemp Pediatr. 2015;2:29-31.

Satti SA, Saadeldin IY, Dammas AS. Diabetic ketoacidosis in children admitted to pediatric intensive care unit of King Fahad Hospital, Al-Baha, Saudi Arabia: Precipitating factors, epidemiological parameters and clinical presentation. Sudan J Paediatr. 2013;13(2):24-30.

Murunga AN, Owira PM. Diabetic ketoacidosis: an overlooked child killer in sub-Saharan Africa? Trop Med Int Health. 2013;18(11):1357-64.

Poovazhagi V, Suresh S. Delayed diagnosis of Diabetic Keto acidsois in children-cause for concern. Int J Diab Developing Countries. 2015;35(2):66-70.

Poovazhagi V. Factors associated with mortality in children with Diabetic Ketoacidosis (DKA) in South India. International Int J Diab Developing Countries. 2016;36(3):295-302.