Amanda Ampt1, Tegan van Gemert2, Maria E Craig3,4,5, Kim C Donaghue3,5, Samantha B Lain1, Natasha Nassar1. 1. Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, The University of Sydney, Camperdown, New South Wales, Australia. 2. Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia. 3. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia. 4. School of Women's and Children's Health, The University of New South Wales, Kensington, New South Wales, Australia. 5. Discipline of Child and Adolescent Health, The University of Sydney, Camperdown, New South Wales, Australia.
Abstract
BACKGROUND: Children with type 1 diabetes (T1D) are at risk of diabetic ketoacidosis (DKA) at T1D diagnosis and/or subsequently. OBJECTIVE: The objective is to determine the incidence and prevalence of T1D by the presence of DKA and identify the characteristics of subsequent DKA episodes. SUBJECTS: The study population included all children aged <15 years with T1D during a hospital/day-stay admission in New South Wales, Australia, from 1 January 2001 to 31 December 2013. T1D and DKA were identified using International Classification of Diseases Australian Modification codes. METHODS: Data sources included routinely collected longitudinally linked population hospitalization and birth records. Chi-squared analyses, logistic, and multinomial regression were used to determine the association between child characteristics and admissions with and without DKA. RESULTS: The point prevalence of T1D among 0-14-year olds on 31 December 2013 was 144.2 per 100 000. For children aged 0-12 years, the incidence of T1D was 16.3 per 100 000 child-years. One-third had DKA at T1D diagnosis and were more likely to be readmitted with DKA than those without DKA at T1D diagnosis. Children with more than one readmission for DKA were more likely to be female, reside in an inner regional area or an area of socioeconomic disadvantage, and be Australian-born. Among all hospitalizations of children with T1D, those with DKA were more likely to be aged 10-14 years, require intensive care, have longer length of stay, and admitted outside school days. CONCLUSION: Routinely collected administrative health data are a reliable source to monitor incidence and health service use of childhood T1D. Children at risk of repeated DKA, particularly females, adolescents, and those from inner regional or socioeconomically disadvantaged areas, should be targeted during education and follow-up.
BACKGROUND:Children with type 1 diabetes (T1D) are at risk of diabetic ketoacidosis (DKA) at T1D diagnosis and/or subsequently. OBJECTIVE: The objective is to determine the incidence and prevalence of T1D by the presence of DKA and identify the characteristics of subsequent DKA episodes. SUBJECTS: The study population included all children aged <15 years with T1D during a hospital/day-stay admission in New South Wales, Australia, from 1 January 2001 to 31 December 2013. T1D and DKA were identified using International Classification of Diseases Australian Modification codes. METHODS: Data sources included routinely collected longitudinally linked population hospitalization and birth records. Chi-squared analyses, logistic, and multinomial regression were used to determine the association between child characteristics and admissions with and without DKA. RESULTS: The point prevalence of T1D among 0-14-year olds on 31 December 2013 was 144.2 per 100 000. For children aged 0-12 years, the incidence of T1D was 16.3 per 100 000 child-years. One-third had DKA at T1D diagnosis and were more likely to be readmitted with DKA than those without DKA at T1D diagnosis. Children with more than one readmission for DKA were more likely to be female, reside in an inner regional area or an area of socioeconomic disadvantage, and be Australian-born. Among all hospitalizations of children with T1D, those with DKA were more likely to be aged 10-14 years, require intensive care, have longer length of stay, and admitted outside school days. CONCLUSION: Routinely collected administrative health data are a reliable source to monitor incidence and health service use of childhood T1D. Children at risk of repeated DKA, particularly females, adolescents, and those from inner regional or socioeconomically disadvantaged areas, should be targeted during education and follow-up.
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