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Wiley InterScience | |||||||||
  Pediatric DiabetesVolume 4 Issue 2, Pages 77 - 81 Published Online: 16 Jun 2003 © 2010 John Wiley & Sons A/S
Abstract | References | Full Text: HTML, PDF (Size: 83K) | Related Articles | Citation Tracking  Original Article Ketoacidosis at onset of type 1 diabetes mellitus in children – frequency and clinical presentation
Copyright Blackwell Munksgaard, 2003 KEYWORDS children • diabetes mellitus • incidence registry • ketoacidosis • subtype Neu A, Willasch A, Ehehalt S, Hub R, Ranke MB on behalf of the DIARY group Baden-Wuerttemberg. Ketoacidosis at onset of type 1 diabetes mellitus in children – frequency and clinical presentation. ABSTRACTBackground: Since 1987, patients with newly diagnosed diabetes mellitus type 1 under 15 yr of age have been registered in Baden-Wuerttemberg (BW), Germany. Aim: Our aim was to describe the frequency and the clinical presentation of diabetic ketoacidosis (DKA) at onset of type 1 diabetes mellitus in children. Methods: All 31 pediatric departments in BW and one diabetes center participated in this study. Hospital records of 2121 children below 15 yr of age were examined retrospectively. DKA was defined as glucose > 250 mg/dL, pH < 7.30 or bicarbonate < 15 mmol/L and ketonuria. Statistical analysis was done after logarithmic transformation. Results: 26.3% (n = 558) of all patients presented with DKA. The mean age of these patients was 7.9 yr. The frequency of DKA is higher in girls than in boys (28.9 vs. 23.8%; p = 0.0079). Those aged 0–4 yr suffered most frequently (p < 0.0001) from ketoacidosis (36.0%). The percentage of DKA in newly diagnosed cases was constant over 10 yr. 23.3% of all patients with DKA presented with an altered level of consciousness; 10.9% of these had clinical signs of coma. No deaths occurred. The proportion of ketoacidosis does not increase concurrently with the number of diabetes manifestations in winter. Conclusion: The proportion of DKA in children with newly diagnosed diabetes mellitus is significant. In particular, children < 5 yr and girls face an increased risk. DKA may be the result of a particularly aggressive subtype of diabetes. Submitted 11 February 2003. Accepted for publication 17 April 2003 | 
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