OBJECTIVE: To define the demographic and clinical characteristics of children at the onset of type 1 diabetes (T1D), with particular attention to the frequency of diabetic ketoacidosis (DKA). STUDY DESIGN: The Pediatric Diabetes Consortium enrolled children with new-onset T1D into a common database. For this report, eligible subjects were aged <19 years, had a pH or HCO(3) value recorded at diagnosis, and were positive for at least one diabetes-associated autoantibody. Of the 1054 children enrolled, 805 met the inclusion criteria. A pH of <7.3 and/or HCO(3) value of <15 mEq/L defined DKA. Data collected included height, weight, hemoglobin A1c, and demographic information (eg, race/ethnicity, health insurance status, parental education, family income). RESULTS: The 805 children had a mean age of 9.2 years, 50% were female; 63% were non-Hispanic Caucasian. Overall, 34% of the children presented in DKA, half with moderate or severe DKA (pH <7.2). The risk for DKA was estimated as 54% in children aged <3 years and 33% in those aged ≥ 3 years (P = .006). In multivariate analysis, younger age (P = .002), lack of private health insurance (P < .001), African-American race (P = .01), and no family history of T1D (P = .001) were independently predictive of DKA. The mean initial hemoglobin A1c was higher in the children with DKA compared with those without DKA (12.5% ± 1.9% vs 11.1% ± 2.4%; P < .001). CONCLUSION: The incidence of DKA in children at the onset of T1D remains high, with approximately one-third presenting with DKA and one-sixth with moderate or severe DKA. Increased awareness of T1D in the medical and lay communities is needed to decrease the incidence of this life-threatening complication.
OBJECTIVE: To define the demographic and clinical characteristics of children at the onset of type 1 diabetes (T1D), with particular attention to the frequency of diabetic ketoacidosis (DKA). STUDY DESIGN: The Pediatric Diabetes Consortium enrolled children with new-onset T1D into a common database. For this report, eligible subjects were aged <19 years, had a pH or HCO(3) value recorded at diagnosis, and were positive for at least one diabetes-associated autoantibody. Of the 1054 children enrolled, 805 met the inclusion criteria. A pH of <7.3 and/or HCO(3) value of <15 mEq/L defined DKA. Data collected included height, weight, hemoglobin A1c, and demographic information (eg, race/ethnicity, health insurance status, parental education, family income). RESULTS: The 805 children had a mean age of 9.2 years, 50% were female; 63% were non-Hispanic Caucasian. Overall, 34% of the children presented in DKA, half with moderate or severe DKA (pH <7.2). The risk for DKA was estimated as 54% in children aged <3 years and 33% in those aged ≥ 3 years (P = .006). In multivariate analysis, younger age (P = .002), lack of private health insurance (P < .001), African-American race (P = .01), and no family history of T1D (P = .001) were independently predictive of DKA. The mean initial hemoglobin A1c was higher in the children with DKA compared with those without DKA (12.5% ± 1.9% vs 11.1% ± 2.4%; P < .001). CONCLUSION: The incidence of DKA in children at the onset of T1D remains high, with approximately one-third presenting with DKA and one-sixth with moderate or severe DKA. Increased awareness of T1D in the medical and lay communities is needed to decrease the incidence of this life-threatening complication.
Authors: Jessica L Harding; Meda E Pavkov; Dianna J Magliano; Jonathan E Shaw; Edward W Gregg Journal: Diabetologia Date: 2018-08-31 Impact factor: 10.122
Authors: Luke Baldelli; Ben Flitter; Laura Pyle; David M Maahs; Georgeanna Klingensmith; Robert Slover; G Todd Alonso Journal: Pediatr Diabetes Date: 2016-10-11 Impact factor: 4.866
Authors: Wei Peng; Jinna Yuan; Valentina Chiavaroli; Guanping Dong; Ke Huang; Wei Wu; Rahim Ullah; Binghan Jin; Hu Lin; José G B Derraik; Junfen Fu Journal: Front Endocrinol (Lausanne) Date: 2021-04-27 Impact factor: 5.555