Ketoacidosis at Diabetes Onset Is Still Frequent in Children and Adolescents
A multicenter analysis of 14,664 patients from 106 institutions
- Andreas Neu, MD1,
- Sabine E. Hofer, MD2,
- Beate Karges, MD3,
- Rudolf Oeverink, MD4,
- Joachim Rosenbauer, MD5,
- Reinhard W. Holl, MD6 and
- for the DPV Initiative and the German BMBF Competency Network for Diabetes Mellitus*
- 1University Children's Hospital, Tübingen, Germany;
- 2Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria;
- 3Department of Endocrinology and Pediatrics, RWTH Aachen University, Aachen, Germany;
- 4Endocrine Consulting Practitioner, Oldenburg, Germany;
- 5Deutsches Diabetes Zentrum, Düsseldorf University, Düsseldorf, Germany;
- 6Department of Epidemiology, University of Ulm, Ulm, Germany.
- Corresponding author: Andreas Neu, andreas.neu{at}med.uni-tuebingen.de.
Abstract
OBJECTIVE We aimed at analyzing the frequency, clinical characteristics, and trends associated with the occurrence of diabetic ketoacidosis (DKA) at the onset of type 1 diabetes on the basis of long-term follow-up data.
RESEARCH DESIGN AND METHODS A total of 106 pediatric diabetes centers in Germany and Austria participated in this study. Data from14,664 patients with type 1 diabetes collected between 1995 and 2007 were suitable for evaluation. DKA was defined and classified according to the International Society for Pediatric and Adolescent Diabetes consensus guidelines.
RESULTS DKA was observed in 21.1% of patients. The frequency of DKA, including the severe form, remained unchanged throughout the 13-year observation period. The frequency of DKA was particularly striking among children <5 years of age (26.5%).
CONCLUSIONS Ketoacidosis occurring at diabetes onset continues to be a difficult problem. Our data show no significant change in the frequency and magnitude of DKA over the last 13 years.
Footnotes
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↵*A complete list of the institutions participating in the Diabetes Prospective Documentation (DPV) Initiative and the German Federal Ministry for Education and Research (BMBF) Competency Network for Diabetes Mellitus can be found in an online appendix at http://care.diabetesjournals.org/cgi/content/full/dc09-0553/DC1.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received March 20, 2009.
- Accepted June 16, 2009.
- © 2009 by the American Diabetes Association.
