DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20185521

Identifying risk factors for development of diabetic ketoacidosis in type 1 diabetes mellitus

G. Anand Kumar, Rajendran ., Swaminathan .

Abstract


Background: DKA [ Diabetic keto acidosis] It is the commonest cause of diabetes-related death in children. Children with diabetic ketoacidosis at diagnosis have poorer glycemic control, to identify the risk factors for the development of Diabetic Ketoacidosis in Type1 Diabetes Mellitus in a tertiary care center.

Methods: The study was conducted in Kovai Medical Centre And Hospital Coimbatore in 2018.22 children were included in present study. Each consultant followed different standard DKA treatment protocols. The two protocols used were Milwaukee and BSPED guidelines.

Results: Among the 22 children, 3 children (13%) had recurrent DKA (>1 episode). One child had his third episode and the rest 2 children had their second episode.19 children had their first episode of DKA.

Conclusions: There was no death among the 22 children treated. This was because of the care is given by the team of doctors and adherence to treatment protocol (Milwaukee or BSPED) of DKA.


Keywords


Cerebral edema, Diabetic keto acidosis, Dyslipidaemia, Hyper glycemia

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References


Hekkala A, Reunanen A, Koski M, Knip M, Veijola R, Finnish Pediatric Diabetes Register. Age-related differences in the frequency of ketoacidosis at diagnosis of type 1 diabet in children and adolescents. Diabetes Care. 2010;33(7):1500-2.

Alaghehbandan R, Collins KD, Newhook LA, MacDonald D. Childhood type 1 diabetes mellitus in Newfoundland and Labrador, Canada. Diabet Res Clinic Pract. 2006;74(1):82-9.

Curtis JR, To T, Muirhead S, Cummings E, Daneman D. Recent trends in hospitalization for diabetic ketoacidosis in Ontario children. Diabet Care. 2002;25(9):1591-6.

Dabelea D, Bell RA, D'Agostino JR, Imperatore G, Johansen JM, Linder B, et al. Incid Diabet Youth United States. JAMA. 2007;297(24):2716-24.

Hekkala A, Knip M, Veijola R. Ketoacidosis at diagnosis of type 1 diabetes in children in northern Finland: temporal changes over 20 years. Diabet Care. 2007;30(4):861-6.

Komulainen J, Kulmala P, Savola K, Lounamaa R, Ilonen J, Reijonen H, et al. Clinical, autoimmune, and genetic characteristics of very young children with type 1 diabetes. Childhood Diabetes in Finland (DiMe) Study Group. Diabees Care. 1999;22(12):1950-5.

Mayer-Davis EJ, Beyer J, Bell RA, Dabelea D, D'agostino R, Imperatore G, et al. Diabetes in African American youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes care. 2009;32(Supplement 2):S112-22.

Neu A, Hofer SE, Karges B. DPV initiative and the German BMBF Competence network for diabetes mellitus. Ketoacidosis at diabetes onset is still frequent in children and adolescents: a multi-centre analysis of 14 664 patients from 106 institutions. Diabet Care. 2009;32:e1647-8.

Patterson CC, Gyürüs E, Rosenbauer J, Cinek O, Neu A, Schober E, et al. Trends in childhood type 1 diabetes incidence in Europe during 1989–2008: evidence of non-uniformity over time in rates of increase. Diabetol. 2012;55(8):2142-7.

Pinhas-Hamiel O, Dolan LM, Zeitler PS. Diabetic ketoacidosis among obese African-American adolescents with NIDDM. Diabet Care. 1997;20(4):484-6.

Pinhas-Hamiel O, Zeitler P. The global spread of type 2 diabetes mellitus in children and adolescents. J Pediatr. 2005;146(5):693-700.

Rewers A, Klingensmith G, Davis C, Petitti DB, Pihoker C, Rodriguez B, et al. Presence of diabetic ketoacidosis at diagnosis of diabetes mellitus in youth: The Search for Diabetes in Youth Study. Pediatrics. 2008;121(5):e1258-66.

Rosenbauer J, Dost A, Karges B, Hungele A, Stahl A, Bächle C, et al. Improved metabolic control in children and adolescents with type 1 diabetes: a trend analysis using prospective multicenter data from Germany and Austria. Diabet Care. 2012;35(1):80-6.

Samuelsson U, Stenhammar L. Clinical characteristics at onset of type 1 diabetes in children diagnosed between 1977 and 2001 in the south-east region of Sweden. Diabet Res Clinic Practice. 2005;68(1):49-55.

Schober E, Rami B, Waldhoer T, Austrian Diabetes Incidence Study Group. Diabetic ketoacidosis at diagnosis in Austrian children in 1989–2008: a population-based analysis. Diabet. 2010;53(6):1057-61.

Scott CR, Smith JM, Cradock MM, Pihoker C. Characteristics of youth-onset noninsulin-dependent diabetes mellitus and insulin-dependent diabetes mellitus at diagnosis. Pediatr. 1997;100(1):84-91.

Sellers EA, Dean HJ. Diabetic ketoacidosis: a complication of type 2 diabetes in Canadian aboriginal youth. Diabet Care. 2000;23(8):1202.

Smith CP, Firth D, Bennett S, Howard C, Chisholm P. Ketoacidosis occurring in newly diagnosed and established diabetic children. Acta Paediatr. 1998;87(5):537-41.

Vehik K, Hamman RF, Lezotte D, Norris JM, Klingensmith G, Bloch C, et al. Increasing incidence of type 1 diabetes in 0-to 17-year-old Colorado youth. Diabet Care. 2007;30(3):503-9.

Zdravkovic V, Daneman D, Hamilton J. Presentation and course of Type 2 diabetes in youth in a large multi‐ethnic city. Diabet Med. 2004;21(10):1144-8.