J Korean Med Sci.  2017 Feb;32(2):303-309. 10.3346/jkms.2017.32.2.303.

Factors Associated with the Presence and Severity of Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes in Korean Children and Adolescents

• Lee HJ
• Yu HW
• Jung HW
• Lee YA
• Kim JH
• Chung HR
• Yoo J
• Kim E
• Yu J
• Shin CH
• Yang SW
• Lee SY

• KMID: 2364175
• DOI: http://doi.org/10.3346/jkms.2017.32.2.303

Abstract

The aim of this study was to identify the risk factors for presence and severity of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes mellitus (T1DM) in Korean children and adolescents. A retrospective chart review of children and adolescents newly diagnosed with T1DM was conducted in seven secondary and tertiary centers in Korea. Eligible subjects were < 20 years of age and had records on the presence or absence of DKA at the time of T1DM diagnosis. DKA severity was categorized as mild, moderate, or severe. Data were collected on age, height, body weight, pubertal status, family history of diabetes, delayed diagnosis, preceding infections, health insurance status, and parental education level. A total of 361 patients (male 46.3%) with T1DM were included. Overall, 177 (49.0%) patients presented with DKA at T1DM diagnosis. Risk factors predicting DKA at T1DM diagnosis were age ≥ 12 years, lower serum C-peptide levels, presence of a preceding infection, and delayed diagnosis. Low parental education level and preceding infection increased the severity of DKA. These results suggest that alertness of the physician and public awareness of diabetes symptoms are needed to decrease the incidence and severity of DKA at T1DM diagnosis.

Keyword

Type 1 Diabetes Mellitus; Diabetic Ketoacidosis; Risk Factors

MeSH Terms

Adolescent*
Body Height
C-Peptide
Child*
Delayed Diagnosis
Diabetes Mellitus, Type 1
Diabetic Ketoacidosis*
Diagnosis*
Education
Humans
Incidence
Insurance, Health
Korea
Parents
Retrospective Studies
Risk Factors
C-Peptide

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