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J Korean Med Sci. 2017 Feb;32(2):303-309. doi: 10.3346/jkms.2017.32.2.303.

Factors Associated with the Presence and Severity of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Korean Children and Adolescents.

Author information

1
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
2
Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea.
3
Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
4
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
5
Department of Pediatrics, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
6
Department of Pediatrics, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.
7
Department of Pediatrics, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
8
Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. gnoygnoes@hanmail.net.

Abstract

The aim of this study was to identify the risk factors for presence and severity of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in Korean children and adolescents. A retrospective chart review of children and adolescents newly diagnosed with T1DM was conducted in seven secondary and tertiary centers in Korea. Eligible subjects were < 20 years of age and had records on the presence or absence of DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe. Data were collected on age, height, body weight, pubertal status, family history of diabetes, delayed diagnosis, preceding infections, health insurance status, and parental education level. A total of 361 patients (male 46.3%) with T1DM were included. Overall, 177 (49.0%) patients presented with DKA at T1DM diagnosis. Risk factors predicting DKA at T1DM diagnosis were age ≥ 12 years, lower serum C-peptide levels, presence of a preceding infection, and delayed diagnosis. Low parental education level and preceding infection increased the severity of DKA. These results suggest that alertness of the physician and public awareness of diabetes symptoms are needed to decrease the incidence and severity of DKA at T1DM diagnosis.

KEYWORDS:

Diabetic Ketoacidosis; Risk Factors; Type 1 Diabetes Mellitus

PMID:
28049242
PMCID:
PMC5219997
DOI:
10.3346/jkms.2017.32.2.303
[Indexed for MEDLINE]
Free PMC Article

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