Incidence of diabetic ketoacidosis

StudyPopulationInterventionOutcomesResultsCommentsDesignEL
Smith, 2001110 029 children and young people with diabetes (previously diagnosed)
Aged 0 to 16 years from 1 January to 31 December 2001
111 sites in the UK
Overnight admission for diabetic ketoacidosis4.5% recorded 1 or more admission
53.2% no admission
42.3% no record either way
The % of children admitted for diabetic ketoacidosis within a centre had a wide variation, from 0% to 32%
Cross-sectional (audit)III
Edge et al, 1999496Deaths caused by diabetes in patients under the age of 20 years between 1990 and 1996 in the UK, from Office of National Statistics (England and Wales)Death116 deaths notified and 83 were caused by diabetes. The standardised mortality ratio was 2.3 (95% CI 1.9 to 2.9), highest for the age group 1–4 years at 9.2 (95% CI 5.4 to 14.7)
Diabetic ketoacidosis or hyperglycaemia was implicated in 83% (69/83) of deaths in patients under the age of 20 years between 1990 and 1996 in the UK
Cerebral oedema caused 69% (25/36) of deaths in children with diabetes under the age of 12
Cross-sectionalIII
Edge et al, 2001499Cases of cerebral oedema in the UK, reported through the British Paediatric Surveillance Unit between October 1995 and September 1998
Episodes of diabetic ketoacidosis reported by 225 paediatricians identified as caring for children with diabetes, between March 1996 and February 1998
Case of cerebral oedema and diabetic ketoacidosisThe risk of developing cerebral oedema was 6.8 per 1000 episodes of diabetic ketoacidosis in all patients with diabetes. (34 cases of cerebral oedema and 2940 cases of diabetic ketoacidosis)
The risk is higher in newly diagnosed patients (11.9 per 1000 episodes) as opposed to patients with established diabetes (3.8 per 1000)
Of the 34 cases of cerebral oedema, 8 resulted in death (24%)
Cross-sectional (audit)III

From: Evidence tables

Cover of Type 1 Diabetes
Type 1 Diabetes: Diagnosis and Management of Type 1 Diabetes in Children and Young People.
NICE Clinical Guidelines, No. 15.2.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2004 Sep.
Copyright © 2004, National Collaborating Centre for Women’s and Children’s Health.

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