Decrease in frequency of ketoacidosis at diabetes onset over the past two decades - perspectives of a paediatric tertiary care centre

• Published in: Diabetic medicine 2012-08, Vol.29 (8), p.e170-e175
• Main Authors: de Vries, L., Oren, L., Lebenthal, Y., Shalitin, S., Lazar, L., Phillip, M.
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; clinical characteristics; Diabetes Mellitus, Type 1 - epidemiology; diabetic ketoacidosis; Diabetic Ketoacidosis - epidemiology; Female; Humans; Incidence; Infant; Israel - epidemiology; Male; Registries; Time Factors; Type 1 diabetes; Young Adult
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2012.03679.x

Diabet. Med. 29, e170–e175 (2012) Aims  To determine whether the frequency and severity of diabetic ketoacidosis and the clinical characteristics of children at diagnosis of Type 1 diabetes mellitus have changed over the past decades among patients under surveillance of a tertiary paediatric centre. Methods  In three time‐periods, 75 (1986–1987), 86 (1996–1997) and 245 (2006–2007) patients at mean age 10.1 ± 4.7 years (0.6–20.0) were diagnosed with new‐onset Type 1 diabetes. Data on clinical characteristics and laboratory evaluation at diagnosis retrieved from the patients’ files . Comparative analysis was performed between the three time periods. Results  The frequency of diabetic ketoacidosis at diagnosis was 40% in 1986–1987, 41.8% in 1996–1997 and 29.4% in 2006–2007; the last rate was significantly lower (P = 0.04). No significant differences in the proportions of patients with severe or moderate diabetic ketoacidosis were found over time. Mean weight standard deviation score significantly increased from −0.72 ± 1.8 in 1986–1987 to −0.27 ± 1.2 in 2006–2007 (P