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Pediatr Diabetes. 2020 Mar 17. doi: 10.1111/pedi.13007. [Epub ahead of print]

Difference in the duration of pediatric diabetic ketoacidosis: Comparison of new-onset to known type 1 diabetes.

Author information

1
Department of Pediatrics, Universidad Nacional de Colombia, Fundación Hospital de la Misericordia, Bogotá, Colombia.
2
Department of Pediatrics, Universidad Nacional de Colombia, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia.
3
Department of Pediatrics, Fundación Universitaria Sanitas, Clínica Universitaria Colombia, Fundación Universitaria de Ciencias de la Salud, Hospital de San José, Bogotá, Colombia.
4
Department of Pediatrics, Universidad Nacional de Colombia, UCIKids, Hospital Infantil Rafael Henao Toro, Manizales, Colombia.
5
Department of Pediatrics, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.
6
Department of Pediatrics, Fundación Universitaria Sanitas, Bogotá, Colombia.
7
Department of Pediatrics, Universidad del Rosario, Clínica Infantil Colsubsidio, Bogotá, Colombia.
8
Department of Pediatrics, Fundación Universitaria de Ciencias de la Salud, Hospital Universitario Infantil de San José, Bogotá, Colombia.

Abstract

OBJECTIVE:

To compare the duration (hours until HCO 3 -  ≥ 15 mmol/L) of diabetic ketoacidosis (DKA) episodes that are the first manifestation of new type 1 diabetes (NT1D) and those that are a complication in patients with previously diagnosed type 1 diabetes (PT1D).

METHODS:

A multicenter retrospective cohort study was designed. The duration of DKA was measured from the start of the treatment. The primary outcome was the comparison of the time needed in each group to reach HCO 3 -  ≥ 15 mmol/L. The secondary outcomes were the comparison of the time to reach pH ≥ 7.3 and length of hospital stay in each group. Data were analyzed with a bivariate analysis of the variables vs primary outcome. Then, a regression model was analyzed. Results There were 305 episodes included (NT1D: 115, PT1D: 190). DKA in the NT1D group lasted longer (NT1D 20 (16-19) vs PT1D 12 (8-16), hours, P < .01) with a significant difference in each level of DKA severity. This group also took longer to reach pH ≥ 7.3 (NT1D 16 (12-22) vs PT1D 9 (6-12), hours, P < .01) and had a longer hospital stay (NT1D 9 (6-12) vs PT1D 7 (4-10), hours, P < .01).

CONCLUSION:

The duration of DKA is longer in patients with NT1D regardless of characteristics like DKA severity, duration of symptoms, and type of treatments received.

KEYWORDS:

acidosis; children; diabetic ketoacidosis; insulin

PMID:
32181961
DOI:
10.1111/pedi.13007

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