Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database
Article first published online: 6 APR 2011
© 2011 John Wiley & Sons A/S
Volume 12, Issue 4pt1, pages 307–312, June 2011
How to Cite
Fritsch, M., Rosenbauer, J., Schober, E., Neu, A., Placzek, K., Holl, R. W. and for the German Competence Network Diabetes Mellitus and the DPV Initiative (2011), Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database. Pediatric Diabetes, 12: 307–312. doi: 10.1111/j.1399-5448.2010.00728.x
- Issue published online: 25 MAY 2011
- Article first published online: 6 APR 2011
- Submitted 25 May 2010. Accepted for publication 8 September 2010
- acute complications;
- diabetic ketoacidosis;
- type 1 diabetes
Fritsch M, Rosenbauer J, Schober E, Neu A, Placzek K, Holl RW. Predictors of diabetic ketoacidosis in children and adolescents with type 1 diabetes. Experience from a large multicentre database.
Objective: Diabetic ketoacidosis (DKA) remains a major cause of hospitalization and death in children and adolescents with established type 1 diabetes despite DKA preventing strategies. The aim of the study was to determine incidence and risk factors for DKA in a large cohort of young diabetic patients.
Methods: This investigation uses the dpv-wiss base containing data on 28 770 patients with type 1 diabetes <20yr, from Germany and Austria. For each patient the most recent year of follow-up was evaluated. DKA was defined as pH < 7.3 and/or hospital admission as a result of DKA, excluding onset DKA.
Results: Mean age of the study cohort was 13.96 ± 4.0 yr (47.9% females). A total of 94.1% presented with no episode, 4.9% with 1 episode, and 1.0% with recurrent DKA (≥2). When comparing these three groups, age (p < 0.01), HbA1c (p < 0.01), and insulin dose (p < 0.01) were significantly higher in patients with recurre nt DKA. Incidence of DKA was significantly higher in females (7.3 ± 0.5 vs. 5.8 ± 0.2; p = 0.03) and in patients with migration background (7.8 ± 0.6 vs. 6.3 ± 0.3; p = 0.02). No significant association was found with treatment type and diabetes duration.
Conclusion: In a cohort of European paediatric diabetic patients, the rate of DKA was significantly higher in females and in children with migration background and early teenage years.