Manuwald U, Schoffer O, Hegewald J, Große J, Kugler J, Kapellen TM, Kiess W, Rothe U. Ketoacidosis at onset of type 1 diabetes in children up to 14 years of age and the changes over a period of 18 years in Saxony, Eastern-Germany: A population based register study.
PLoS One 2019;
14:e0218807. [PMID:
31220176 PMCID:
PMC6586407 DOI:
10.1371/journal.pone.0218807]
[Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/10/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE
The aim of this study was to examine the incidence trends of type 1 diabetes diagnosed with ketoacidosis in Saxony, Germany from 1999 to 2016.
METHODS
The population based Childhood Diabetes Registry of Saxony comprising valid data for all children aged 0-14 years diagnosed with type 1 diabetes from1999 to 2016 were used for the analyses. Direct age-standardized incidence rates were calculated and the effects of age, sex, calendar year, home districts and family history of any types of diabetes on the incidence were modelled using Poisson regression. Trend analyses for standard rate ratios of children with moderate and severe diabetic ketoacidosis versus children with type 1 diabetes with non-diabetic ketoacidosis were performed using join point regression.
RESULTS
The rate of ketoacidosis at the time of the type 1 diabetes diagnosis was high with 35.2% during the entire observation period in Saxony. The Poisson regression analysis indicated a statistically significant increased occurrence of diabetic ketoacidosis for younger age-groups, but no statistically significant differences between boys and girls. The join point trend analyses show that the proportion of severe and moderate ketoacidosis is increasing disproportionally to the increase in incidence of type 1 diabetes over the years.
CONCLUSION
Due to the observed increasing incidence of diabetes as well of diabetic ketoacidosis, an educational prevention campaign is needed in Saxony as soon as possible to aid pediatricians, general physicians as well as general public to identify the early signs of type 1 diabetes.
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