Martínez E, Portillo N, Lizarralde E, Grau G, Vela A, Rodríguez A, Rica I. For Debate: Paediatric T1DM: DKA is Still a Problem.
Pediatr Endocrinol Rev 2018;
16:233-239. [PMID:
30556656 DOI:
10.17458/per.vol16.2018.mpr.fd.t1dmdka]
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Abstract
Although the treatment of pediatric patients with T1DM has improved ketoacidosis (DKA) remains a frequent problem.
OBJECTIVE
To estimate temporal changes in the prevalence of DKA at diagnosis of T1DM and to explore the factors associated with its occurrence.
METHODS
Paediatric patients diagnosed at Cruces University Hospital (Spain) since 1997 were included. Clinical/analytical variables at diabetes onset, Hemoglobin A1c level during the first 2 years of evolution and the presence of the honeymoon phase were studied.
RESULTS
In 209 patients the prevalence of DKA was stable over time and high (35.4%) especially in the youngest. 8.5% of patients had a severe DKA with a higher risk in older than 10. Partial remission occurred in 26% patients, less frequent in the youngest and in the subgroup with DKA at diagnosis.
CONCLUSION
The frequency of DKA although stable, remains high and is associated with a worse evolution of the disease.
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